Provider Demographics
NPI:1295912822
Name:WEISS PHYSICAL THERAPY ASSOCIATES
Entity type:Organization
Organization Name:WEISS PHYSICAL THERAPY ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:717-697-4000
Mailing Address - Street 1:601 E SIMPSON ST
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-3456
Mailing Address - Country:US
Mailing Address - Phone:717-691-7100
Mailing Address - Fax:717-691-6855
Practice Address - Street 1:1700 BENT CREEK BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-1870
Practice Address - Country:US
Practice Address - Phone:717-697-4000
Practice Address - Fax:717-697-4004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016114-L261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1811997091OtherINDIVIDUAL NPI
PA1811997091OtherINDIVIDUAL NPI