Provider Demographics
NPI:1396015913
Name:WHITNEY PHYSICAL THERAPY L.L.C.
Entity Type:Organization
Organization Name:WHITNEY PHYSICAL THERAPY L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:814-764-5356
Mailing Address - Street 1:289 DEER RUN RD
Mailing Address - Street 2:
Mailing Address - City:CORSICA
Mailing Address - State:PA
Mailing Address - Zip Code:15829-1829
Mailing Address - Country:US
Mailing Address - Phone:814-764-5356
Mailing Address - Fax:814-764-3143
Practice Address - Street 1:16171 ROUTE 322
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-6347
Practice Address - Country:US
Practice Address - Phone:814-764-3134
Practice Address - Fax:814-764-3143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012709L261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy