Provider Demographics
NPI:1114907177
Name:RICHARD L HOLZWORTH
Entity Type:Organization
Organization Name:RICHARD L HOLZWORTH
Other - Org Name:PENN-OHIO REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOLZWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:724-962-7920
Mailing Address - Street 1:1599 NORTH HERMITAGE RD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148
Mailing Address - Country:US
Mailing Address - Phone:724-962-7920
Mailing Address - Fax:724-962-6029
Practice Address - Street 1:1599 NORTH HERMITAGE RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148
Practice Address - Country:US
Practice Address - Phone:724-962-7920
Practice Address - Fax:724-962-6029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA025221OtherMEDICARE GROUP
PA023575M45OtherREBECCA SYERSAK
PA023572M45OtherLARRY MATTOCKS
PA104392OtherUPMC
PA220033OtherHEALTH AMERICA/HEALTH ASSURANCE
PA517630M45OtherRICHARD L HOLZWORTH
PA548783OtherHIGHMARK
PADE6719OtherRAILROAD MEDICARE
PA042150M45OtherDOUGLAS ORENDI
PA095209M45OtherKRISTEN NOLLINGER