Provider Demographics
NPI:1275931099
Name:PERKINS, MARK (PT)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:PERKINS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1099 PITTSBURGH RD
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:PA
Mailing Address - Zip Code:16059-1934
Mailing Address - Country:US
Mailing Address - Phone:724-687-8120
Mailing Address - Fax:724-687-8121
Practice Address - Street 1:1099 PITTSBURGH RD
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:PA
Practice Address - Zip Code:16059-1934
Practice Address - Country:US
Practice Address - Phone:724-687-8120
Practice Address - Fax:724-687-8121
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT029224261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy