Provider Demographics
NPI:1689619868
Name:LAWRENCE COUNTY PHYSICAL THERAPY INSTITUTE
Entity Type:Organization
Organization Name:LAWRENCE COUNTY PHYSICAL THERAPY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:THOMPSON
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, ATC
Authorized Official - Phone:724-652-4334
Mailing Address - Street 1:2730 ELLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-6276
Mailing Address - Country:US
Mailing Address - Phone:724-652-4334
Mailing Address - Fax:724-652-1491
Practice Address - Street 1:2730 ELLWOOD RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-6276
Practice Address - Country:US
Practice Address - Phone:724-652-4334
Practice Address - Fax:724-652-1491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2009-05-26
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
PA0018725900005Medicaid
PA0018725900005Medicaid