Basic Information
| Provider Information | |||||||||
| NPI: | 1184793978 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHYSIOTHERAPY ASSOCIATES INC | ||||||||
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| OtherOrganizationName: | PHYSIOTHERAPY ASSOCIATES | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 665 PHILADELPHIA ST | ||||||||
| Address2: | STE 200 | ||||||||
| City: | INDIANA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 157013941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7244653496 | ||||||||
| FaxNumber: | 7244653726 | ||||||||
| Practice Location | |||||||||
| Address1: | 1488 JESSE JEWELL PKWY SE | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305013803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7705358850 | ||||||||
| FaxNumber: | 7705358853 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2006 | ||||||||
| LastUpdateDate: | 11/12/2008 | ||||||||
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| AuthorizedOfficialLastName: | FITZPATRICK | ||||||||
| AuthorizedOfficialFirstName: | DENNIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 6106447824 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.