Provider Demographics
NPI:1831297100
Name:WASHINGTON CENTRE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:WASHINGTON CENTRE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGAER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:S
Authorized Official - Last Name:WERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATIVE
Authorized Official - Phone:724-652-4444
Mailing Address - Street 1:8 N MILL ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-3610
Mailing Address - Country:US
Mailing Address - Phone:724-654-2444
Mailing Address - Fax:
Practice Address - Street 1:8 N MILL ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-3610
Practice Address - Country:US
Practice Address - Phone:724-654-2444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA020750MYUMedicare ID - Type UnspecifiedPHYSICAL THERAPIST
PA034842MYUMedicare ID - Type UnspecifiedPHYSICAL THERAPIST