Provider Demographics
NPI:1003031295
Name:CONTOUR FORM PRODUCTS INC
Entity Type:Organization
Organization Name:CONTOUR FORM PRODUCTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KRONER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:724-588-4452
Mailing Address - Street 1:38 STEWART AVE
Mailing Address - Street 2:P.O. BOX 328
Mailing Address - City:GREENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16125-1978
Mailing Address - Country:US
Mailing Address - Phone:724-588-4452
Mailing Address - Fax:
Practice Address - Street 1:38 STEWART AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:PA
Practice Address - Zip Code:16125-1978
Practice Address - Country:US
Practice Address - Phone:724-588-4452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-14
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002057L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA054280Medicare UPIN