Provider Demographics
NPI:1073658217
Name:ARMITAGE, JOHN BRENDAN (PT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:BRENDAN
Last Name:ARMITAGE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2953 BROOKFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-3557
Mailing Address - Country:US
Mailing Address - Phone:717-569-6660
Mailing Address - Fax:
Practice Address - Street 1:2953 BROOKFIELD RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3557
Practice Address - Country:US
Practice Address - Phone:717-569-6660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPTO16091225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1017300970001OtherMA PROVIDER NUMBER