Provider Demographics
NPI:1497049878
Name:DRAYER PHYSICAL THERAPY INSTITUTE LLC
Entity Type:Organization
Organization Name:DRAYER PHYSICAL THERAPY INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-220-2100
Mailing Address - Street 1:120 N BALTIMORE ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DILLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17019-1212
Mailing Address - Country:US
Mailing Address - Phone:717-502-3100
Mailing Address - Fax:717-502-3101
Practice Address - Street 1:120 N BALTIMORE ST
Practice Address - Street 2:SUITE 110
Practice Address - City:DILLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17019-1212
Practice Address - Country:US
Practice Address - Phone:717-502-3100
Practice Address - Fax:717-502-3101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-03
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA075125Medicare Oscar/Certification