Provider Demographics
NPI:1801840301
Name:RASCONA PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:RASCONA PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:RASCONA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:814-443-2933
Mailing Address - Street 1:917 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-1213
Mailing Address - Country:US
Mailing Address - Phone:814-443-2933
Mailing Address - Fax:814-443-4695
Practice Address - Street 1:917 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-1213
Practice Address - Country:US
Practice Address - Phone:814-443-2933
Practice Address - Fax:814-443-4695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty