Provider Demographics
NPI:1699020131
Name:MOSLAK, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MOSLAK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 PENN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-2044
Mailing Address - Country:US
Mailing Address - Phone:814-695-2923
Mailing Address - Fax:814-695-2924
Practice Address - Street 1:911 N FRONT ST
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-8264
Practice Address - Country:US
Practice Address - Phone:814-342-3930
Practice Address - Fax:814-342-3935
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022194225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist