Provider Demographics
NPI:1972069813
Name:JAMIE P. DIANDRETH PHYSICAL THERAPY
Entity Type:Organization
Organization Name:JAMIE P. DIANDRETH PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIANDRETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-830-8815
Mailing Address - Street 1:4536 ROUTE 136 STE 12
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7918
Mailing Address - Country:US
Mailing Address - Phone:724-830-8815
Mailing Address - Fax:724-830-8813
Practice Address - Street 1:4536 ROUTE 136 STE 12
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-7918
Practice Address - Country:US
Practice Address - Phone:724-830-8815
Practice Address - Fax:724-830-8813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-15
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy