Provider Demographics
NPI:1003415829
Name:ORTHOPEDIC AND SPORTS PHYSICAL THERAPY ASSOCIATES INC
Entity Type:Organization
Organization Name:ORTHOPEDIC AND SPORTS PHYSICAL THERAPY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:ELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOJARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-483-2159
Mailing Address - Street 1:625 LINCOLN AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-2451
Mailing Address - Country:US
Mailing Address - Phone:724-483-3610
Mailing Address - Fax:
Practice Address - Street 1:915 MOUNT ROYAL BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15223-1046
Practice Address - Country:US
Practice Address - Phone:412-213-0845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty