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NPI Code Detail

MEDICARE: GO SPORT PHYSICAL THERAPY INC

MEDICARE: GO SPORT PHYSICAL THERAPY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11523358OTHERPAGATEWAY GROUP #
2646309OTHERPAHIGHMARK BS GROUP #
3LP83OTHERMDCAREFIRST GROUP #
4T709OTHERMDNAT'L CAP CARE GROUP#
502442200OTHERPACAPITAL BC GROUP PROV #
6131854OTHERPAMEDPLUS GROUP #
720021541OTHERPAAMERIHEALTH MERCY GRP#
8206108OTHERPAHEALTH AMER/ASSUR GRP#
9364765200OTHERPAUS DEPT OF LABOR GRP#
10MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
112119160OTHERPAAETNA GROUP PROV #

General Provider Information

NPI Number : 1891753752
Entity Type Code : Organization
Provider Name (Legal Business Name) : GO SPORT PHYSICAL THERAPY INC
Provider Business Mailing Address
First Line : 16C DEATRICK DR
Second Line :
City : GETTYSBURG
State : PA
Zip : 17325-6958
Country : US
Telephone Number : 717-337-3300
Fax Number : 717-337-2977
Provider Business Practice Location Address
First Line : 16C DEATRICK DR
Second Line :
City : GETTYSBURG
State : PA
Zip : 17325-6958
Country : US
Telephone Number : 717-337-3300
Fax Number : 717-337-2977
Authorized Official
Title or Position : PRESIDENT
Name : JONATHAN SCOTT LEWIS
Credential : DPT
Telephone Number : 717-337-3300
Provider Enumeration Date : 05/02/2006
Last Update Date : 08/11/2009

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Directions to “GO SPORT PHYSICAL THERAPY INC ” Practice Location

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