Provider Demographics
NPI:1578638482
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:PRESIDENT AND 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 1:3 JENNIFER CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-7693
Mailing Address - Country:US
Mailing Address - Phone:717-243-0271
Mailing Address - Fax:717-243-0531
Practice Address - Street 1:3 JENNIFER CT
Practice Address - Street 2:SUITE A
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-7693
Practice Address - Country:US
Practice Address - Phone:717-243-0271
Practice Address - Fax:717-243-0531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA075125Medicare Oscar/Certification
PA075125Medicare PIN