Provider Demographics
NPI:1043214455
Name:PHYSICAL REHABILITATION SERVICES INC
Entity Type:Organization
Organization Name:PHYSICAL REHABILITATION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BUTCH
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MS, ATC
Authorized Official - Phone:412-366-3880
Mailing Address - Street 1:1033 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2123
Mailing Address - Country:US
Mailing Address - Phone:412-366-3880
Mailing Address - Fax:412-366-7655
Practice Address - Street 1:1033 PERRY HWY
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2123
Practice Address - Country:US
Practice Address - Phone:412-366-3880
Practice Address - Fax:412-366-7655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA561758OtherHIGHMARK GROUP NUMBER
PA023975Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
PA650014022Medicare ID - Type UnspecifiedRAILROAD MEDICARE GROUP