Provider Demographics
NPI:1619958246
Name:CARDMAN, CURTIS S (PT)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:S
Last Name:CARDMAN
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 1:9125 RIDGE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:GIRARD
Mailing Address - State:PA
Mailing Address - Zip Code:16417-9645
Mailing Address - Country:US
Mailing Address - Phone:814-774-4100
Mailing Address - Fax:814-774-1172
Practice Address - Street 1:6000 W RIDGE RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-1040
Practice Address - Country:US
Practice Address - Phone:814-315-3998
Practice Address - Fax:814-315-2557
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008392L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024216300001Medicaid