Provider Demographics
NPI:1255689725
Name:THROWER, MICHAEL (PT, DPT, ATC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:THROWER
Suffix:
Gender:M
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 NAZARETH RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8336
Mailing Address - Country:US
Mailing Address - Phone:610-253-1000
Mailing Address - Fax:610-253-4333
Practice Address - Street 1:3601 NAZARETH RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8336
Practice Address - Country:US
Practice Address - Phone:610-253-1000
Practice Address - Fax:610-253-4333
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2711225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV36885Medicare PIN
NVGM841ZMedicare PIN