Provider Demographics
NPI:1285815217
Name:SAYLOR, COLLEEN MOREA (PT)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:MOREA
Last Name:SAYLOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:COLLEEN
Other - Middle Name:MARIE
Other - Last Name:MOREA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:113 WESTWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-3315
Mailing Address - Country:US
Mailing Address - Phone:814-360-7147
Mailing Address - Fax:
Practice Address - Street 1:113 WESTWOOD CIR
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-3315
Practice Address - Country:US
Practice Address - Phone:814-360-7147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008982L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101104020001Medicaid