Provider Demographics
NPI:1629208111
Name:ORTHOPEDIC & SPORTS PHYSICAL THERAPY ASSOCIATES, INC
Entity Type:Organization
Organization Name:ORTHOPEDIC & SPORTS PHYSICAL THERAPY ASSOCIATES, INC
Other - Org Name:HAND AND UPPER EXTREMITY REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GRECO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-483-1673
Mailing Address - Street 1:625 LINCOLN AVE
Mailing Address - Street 2:SUITE 107 PROFESSIONAL PLAZA
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-2451
Mailing Address - Country:US
Mailing Address - Phone:724-483-1673
Mailing Address - Fax:724-483-0290
Practice Address - Street 1:3109 UNIVERSITY AVE
Practice Address - Street 2:SUITE C, SELLARO PLAZA
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3205
Practice Address - Country:US
Practice Address - Phone:304-241-4020
Practice Address - Fax:304-241-4029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment