Provider Demographics
NPI:1518334952
Name:ALLEGRETTO, PAUL (MSPT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:ALLEGRETTO
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111-113 COBB ST.
Mailing Address - Street 2:
Mailing Address - City:JOHNSONBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15845
Mailing Address - Country:US
Mailing Address - Phone:814-965-5279
Mailing Address - Fax:814-965-4251
Practice Address - Street 1:111-113 COBB ST.
Practice Address - Street 2:
Practice Address - City:JOHNSONBURG
Practice Address - State:PA
Practice Address - Zip Code:15845
Practice Address - Country:US
Practice Address - Phone:814-965-5279
Practice Address - Fax:814-965-4251
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016645225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist