Provider Demographics
NPI:1255664272
Name:MILESTONES PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:MILESTONES PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:MISHIC
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:814-598-6422
Mailing Address - Street 1:39 MIDWAY RD
Mailing Address - Street 2:
Mailing Address - City:KANE
Mailing Address - State:PA
Mailing Address - Zip Code:16735-4429
Mailing Address - Country:US
Mailing Address - Phone:814-598-6422
Mailing Address - Fax:814-837-6237
Practice Address - Street 1:39 MIDWAY RD
Practice Address - Street 2:
Practice Address - City:KANE
Practice Address - State:PA
Practice Address - Zip Code:16735-4429
Practice Address - Country:US
Practice Address - Phone:814-598-6422
Practice Address - Fax:814-837-6237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013931L2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty