Provider Demographics
NPI:1629606843
Name:P.O.C. CONVERTER LLC
Entity Type:Organization
Organization Name:P.O.C. CONVERTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:JIANCRISTOFORO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:412-215-6685
Mailing Address - Street 1:9234 ABBEY LN
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-4393
Mailing Address - Country:US
Mailing Address - Phone:412-215-6685
Mailing Address - Fax:
Practice Address - Street 1:9234 ABBEY LN
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-4393
Practice Address - Country:US
Practice Address - Phone:412-215-6685
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty