Provider Demographics
NPI:1043435696
Name:COLUMBRO, JANET MIDDLETON (ATC)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:MIDDLETON
Last Name:COLUMBRO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:ORELAND
Mailing Address - State:PA
Mailing Address - Zip Code:19075-2525
Mailing Address - Country:US
Mailing Address - Phone:215-233-9124
Mailing Address - Fax:
Practice Address - Street 1:120 W WISSAHICKON AVE
Practice Address - Street 2:
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-1802
Practice Address - Country:US
Practice Address - Phone:215-233-9124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART000098A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer