Provider Demographics
NPI:1346522976
Name:SUMMIT PHYSICAL THERAPY. INC
Entity Type:Organization
Organization Name:SUMMIT PHYSICAL THERAPY. INC
Other - Org Name:SUMMIT PHYSICAL THERAPY AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MASCIO
Authorized Official - Suffix:
Authorized Official - Credentials:LPT
Authorized Official - Phone:304-723-3780
Mailing Address - Street 1:414 PENCO RD
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-3822
Mailing Address - Country:US
Mailing Address - Phone:304-723-3780
Mailing Address - Fax:304-723-4110
Practice Address - Street 1:100 WILHAVEN RD
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3008
Practice Address - Country:US
Practice Address - Phone:304-723-3780
Practice Address - Fax:304-723-4110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty