Provider Demographics
NPI:1245012301
Name:PERLIK, BOBBI JO (LMT)
Entity type:Individual
Prefix:
First Name:BOBBI
Middle Name:JO
Last Name:PERLIK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TRANSFER
Mailing Address - State:PA
Mailing Address - Zip Code:16154-2408
Mailing Address - Country:US
Mailing Address - Phone:724-734-6361
Mailing Address - Fax:
Practice Address - Street 1:2539 WILMINGTON RD STE C
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1636
Practice Address - Country:US
Practice Address - Phone:724-657-5156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG005378225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist