Provider Demographics
NPI:1356568687
Name:LEMONT PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:LEMONT PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-POSITION
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:FLICK
Authorized Official - Suffix:
Authorized Official - Credentials:PT, CLT
Authorized Official - Phone:814-861-6608
Mailing Address - Street 1:165 CENTENNIAL HILLS RD
Mailing Address - Street 2:
Mailing Address - City:PORT MATILDA
Mailing Address - State:PA
Mailing Address - Zip Code:16870-8312
Mailing Address - Country:US
Mailing Address - Phone:814-861-6608
Mailing Address - Fax:814-861-6610
Practice Address - Street 1:2766 W COLLEGE AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-2647
Practice Address - Country:US
Practice Address - Phone:814-861-6608
Practice Address - Fax:814-861-6610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT010739L261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00719859OtherHIGHMARK BLUE SHIELD
PA255448OtherHEALTH AMERICA
PA255448OtherHEALTH ASSURANCE
PA255448OtherADVANTRA
PA255448OtherCENTRAL PA TEAMSTERS
PA50044205OtherNCAS PENNSYLVANIA
PA255448OtherADVANTRA FREEDOM
PA50044205OtherCAPITAL BLUE CROSS
PA92766OtherGEISINGER HEALTH PLAN
PA50044205OtherCAPITAL BLUE CROSS