Provider Demographics
NPI:1497753180
Name:STYBORSKI, JOHN MARK (MPT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:MARK
Last Name:STYBORSKI
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:CORRY
Mailing Address - State:PA
Mailing Address - Zip Code:16407-1622
Mailing Address - Country:US
Mailing Address - Phone:814-663-7878
Mailing Address - Fax:814-663-0661
Practice Address - Street 1:41 N CENTER ST
Practice Address - Street 2:
Practice Address - City:CORRY
Practice Address - State:PA
Practice Address - Zip Code:16407-1622
Practice Address - Country:US
Practice Address - Phone:814-663-7878
Practice Address - Fax:814-663-0661
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA012820L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00026963101OtherUNIVERA
PA000915726OtherHIGHMARK
PA232242OtherHEALTHAMERICA
PA043294SKCMedicare ID - Type Unspecified