Provider Demographics
NPI:1205930849
Name:PUSKARICH, JOHN M (PT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:M
Last Name:PUSKARICH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:220 WINDING KNOLL RD
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4314
Mailing Address - Country:US
Mailing Address - Phone:814-943-6846
Mailing Address - Fax:814-941-9981
Practice Address - Street 1:626 WATER STREET
Practice Address - Street 2:
Practice Address - City:ORBISONIA
Practice Address - State:PA
Practice Address - Zip Code:17243
Practice Address - Country:US
Practice Address - Phone:814-447-5521
Practice Address - Fax:814-447-3966
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT001448E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist