Provider Demographics
NPI:1558762781
Name:BLAHOVEC, ZACHARY (PT)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:BLAHOVEC
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 LINCOLN AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:N CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-2451
Mailing Address - Country:US
Mailing Address - Phone:724-483-3610
Mailing Address - Fax:724-489-4758
Practice Address - Street 1:54 LEBANON AVE
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-4127
Practice Address - Country:US
Practice Address - Phone:724-439-6294
Practice Address - Fax:724-439-8947
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023849225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist