Provider Demographics
NPI:1093062689
Name:PATTON REHABILITATION ASSOCIATES INC
Entity Type:Organization
Organization Name:PATTON REHABILITATION ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:KRUG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:814-674-2218
Mailing Address - Street 1:503 RAILROAD AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PATTON
Mailing Address - State:PA
Mailing Address - Zip Code:16668-1342
Mailing Address - Country:US
Mailing Address - Phone:814-674-2218
Mailing Address - Fax:814-674-3716
Practice Address - Street 1:503 RAILROAD AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:PATTON
Practice Address - State:PA
Practice Address - Zip Code:16668-1342
Practice Address - Country:US
Practice Address - Phone:814-674-2218
Practice Address - Fax:814-674-3716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-14
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT003879L261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy