Provider Demographics
NPI:1609835651
Name:BETH A. CARR PT INC
Entity Type:Organization
Organization Name:BETH A. CARR PT INC
Other - Org Name:CARR PHYSICAL THERAPY CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:C
Authorized Official - Last Name:COMFORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-473-3912
Mailing Address - Street 1:PO BOX 64
Mailing Address - Street 2:845 WATER STREET
Mailing Address - City:NORTHUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17857-0064
Mailing Address - Country:US
Mailing Address - Phone:570-473-3912
Mailing Address - Fax:540-473-8731
Practice Address - Street 1:845 WATER ST
Practice Address - Street 2:
Practice Address - City:NORTHUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17857-1243
Practice Address - Country:US
Practice Address - Phone:570-473-3912
Practice Address - Fax:540-473-8731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA032559Medicare PIN