Provider Demographics
NPI:1922495332
Name:COMMUNITY THERAPY AND SPORTS MEDICINE INC
Entity Type:Organization
Organization Name:COMMUNITY THERAPY AND SPORTS MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAZA
Authorized Official - Middle Name:IMTIAZ-AHMAD
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-261-2546
Mailing Address - Street 1:1035 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-2986
Mailing Address - Country:US
Mailing Address - Phone:717-261-2546
Mailing Address - Fax:717-263-3614
Practice Address - Street 1:1035 WAYNE AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2986
Practice Address - Country:US
Practice Address - Phone:717-261-2546
Practice Address - Fax:717-263-3614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy