Provider Demographics
NPI:1417209693
Name:A-K VALLEY PHYSICAL MEDICINE LLC
Entity Type:Organization
Organization Name:A-K VALLEY PHYSICAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEC
Authorized Official - Middle Name:
Authorized Official - Last Name:CIRIGLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-339-0370
Mailing Address - Street 1:1170 WILDLIFE LODGE RD
Mailing Address - Street 2:
Mailing Address - City:LOWER BURRELL
Mailing Address - State:PA
Mailing Address - Zip Code:15068-3562
Mailing Address - Country:US
Mailing Address - Phone:724-339-0370
Mailing Address - Fax:
Practice Address - Street 1:1170 WILDLIFE LODGE RD
Practice Address - Street 2:
Practice Address - City:LOWER BURRELL
Practice Address - State:PA
Practice Address - Zip Code:15068-3562
Practice Address - Country:US
Practice Address - Phone:724-339-0370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014379207QS0010X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty