Basic Information
| Provider Information | |||||||||
| NPI: | 1356804017 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLOOR | ||||||||
| FirstName: | MIRANDA | ||||||||
| MiddleName: | JO | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 625 WALNUT ST | ||||||||
| Address2: | |||||||||
| City: | MCKEESPORT | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151322806 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 FAIRFIELD DR | ||||||||
| Address2: | |||||||||
| City: | SENECA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 163462130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8146767932 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2019 | ||||||||
| LastUpdateDate: | 03/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT026399 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.