Provider Demographics
NPI:1225025695
Name:WARDROP, RICHARD BELL (MS, PT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:BELL
Last Name:WARDROP
Suffix:
Gender:M
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2746 KINGSTON DR
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-1731
Mailing Address - Country:US
Mailing Address - Phone:724-224-8717
Mailing Address - Fax:
Practice Address - Street 1:2746 KINGSTON DR
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-1731
Practice Address - Country:US
Practice Address - Phone:724-224-8717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT005614L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015330120004Medicaid
PA167394OtherTHREE RIVERS
PA000762633OtherHIGHMARK BC/BS