Provider Demographics
NPI:1811019094
Name:PEIGHTEL, THOMAS W (PT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:W
Last Name:PEIGHTEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17102-3318
Mailing Address - Country:US
Mailing Address - Phone:717-475-5912
Mailing Address - Fax:717-475-5912
Practice Address - Street 1:1109 N FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17102-3318
Practice Address - Country:US
Practice Address - Phone:717-475-5912
Practice Address - Fax:717-475-5912
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006705L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT006705LOtherPHYSICAL THERAPIST LICEN.