Provider Demographics
NPI:1346478682
Name:WARNER, TIFFANY T (PT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:T
Last Name:WARNER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:T
Other - Last Name:STRUCHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:77 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:PA
Mailing Address - Zip Code:16401-1137
Mailing Address - Country:US
Mailing Address - Phone:814-490-3129
Mailing Address - Fax:
Practice Address - Street 1:1012 WATER ST
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3468
Practice Address - Country:US
Practice Address - Phone:814-337-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-019967225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist