Provider Demographics
NPI:1588602510
Name:PHYSIOTHERAPY ASSOCIATES, INC
Entity Type:Organization
Organization Name:PHYSIOTHERAPY ASSOCIATES, INC
Other - Org Name:PHYSIOTHERAPY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAYNE
Authorized Official - Middle Name:FLECK
Authorized Official - Last Name:POOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-465-3496
Mailing Address - Street 1:P.O. BOX 1245
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-5245
Mailing Address - Country:US
Mailing Address - Phone:724-465-3496
Mailing Address - Fax:215-413-4682
Practice Address - Street 1:108C W INSKIP DRIVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-4017
Practice Address - Country:US
Practice Address - Phone:865-219-9600
Practice Address - Fax:865-219-9584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP.T.2285225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0626451OtherCIGNA
TN0446557Medicaid
TN5186150OtherAETNA
TN644001OtherUNITED HEALTHCARE
TN0626451OtherCIGNA
TN644001OtherUNITED HEALTHCARE