Basic Information
Provider Information
NPI: 1558306662
EntityType: 2
ReplacementNPI:  
OrganizationName: INTEGRITY PHYSICAL THERAPY INC
LastName:  
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Mailing Information
Address1: PO BOX 1245
Address2:  
City: INDIANA
State: PA
PostalCode: 157015245
CountryCode: US
TelephoneNumber: 7244653496
FaxNumber: 2154134682
Practice Location
Address1: 436 E RIVER ST
Address2: SUITE 6
City: ELYRIA
State: OH
PostalCode: 440355200
CountryCode: US
TelephoneNumber: 4403221667
FaxNumber: 4402845987
Other Information
ProviderEnumerationDate: 06/20/2006
LastUpdateDate: 12/06/2011
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: POOL
AuthorizedOfficialFirstName: JAYNE
AuthorizedOfficialMiddleName: FLECK
AuthorizedOfficialTitleorPosition: CHIEF COMPLIANCE OFFICER
AuthorizedOfficialTelephone: 4694678705
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QP2000X  Y Ambulatory Health Care FacilitiesClinic/CenterPhysical Therapy

No ID Information.


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