Provider Demographics
NPI:1225173651
Name:JEANNETTE PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:JEANNETTE PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, PT
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:724-523-8809
Mailing Address - Street 1:1117 LOWRY AVE
Mailing Address - Street 2:BUILDING C
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-3074
Mailing Address - Country:US
Mailing Address - Phone:724-523-8809
Mailing Address - Fax:724-523-8812
Practice Address - Street 1:1117 LOWRY AVE
Practice Address - Street 2:BUILDING C
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-3074
Practice Address - Country:US
Practice Address - Phone:724-523-8809
Practice Address - Fax:724-523-8812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007192L261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA573616OtherHIGHMARK
PA5807310OtherAETNA PPO
PA2380545OtherAETNA
PA2255316OtherHEALTH AMERICA
PAS72188Medicare UPIN
PA002775Medicare PIN