Provider Demographics
NPI:1003235987
Name:LEBANON VALLEY COLLEGE PHYSICAL THERAPY AND SPORTS REHABILITATION
Entity Type:Organization
Organization Name:LEBANON VALLEY COLLEGE PHYSICAL THERAPY AND SPORTS REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIR, BOARD OF MANAGERS
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:CURTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-867-6207
Mailing Address - Street 1:101 N COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:ANNVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17003-1404
Mailing Address - Country:US
Mailing Address - Phone:717-867-6848
Mailing Address - Fax:
Practice Address - Street 1:101 N COLLEGE AVE
Practice Address - Street 2:PHYSICAL THERAPY CLINIC
Practice Address - City:ANNVILLE
Practice Address - State:PA
Practice Address - Zip Code:17003-1404
Practice Address - Country:US
Practice Address - Phone:717-867-6848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy