Provider Demographics
NPI:1275259640
Name:FORGE PERFORMANCE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:FORGE PERFORMANCE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:VIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-212-0302
Mailing Address - Street 1:4156 LIBRARY RD STE 3
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15234-1349
Mailing Address - Country:US
Mailing Address - Phone:412-212-0302
Mailing Address - Fax:
Practice Address - Street 1:4156 LIBRARY RD STE 3
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15234-1349
Practice Address - Country:US
Practice Address - Phone:412-212-0302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty