Provider Demographics
NPI:1740313691
Name:PENN-TRAFFORD PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:PENN-TRAFFORD PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:HUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:724-744-7200
Mailing Address - Street 1:1004 HARRISON CITY EXPORT RD
Mailing Address - Street 2:
Mailing Address - City:HARRISON CITY
Mailing Address - State:PA
Mailing Address - Zip Code:15636-1340
Mailing Address - Country:US
Mailing Address - Phone:724-744-7200
Mailing Address - Fax:
Practice Address - Street 1:1004 HARRISON CITY EXPORT RD
Practice Address - Street 2:
Practice Address - City:HARRISON CITY
Practice Address - State:PA
Practice Address - Zip Code:15636-1340
Practice Address - Country:US
Practice Address - Phone:724-744-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007113L261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6015123OtherCIGNA
PA808490OtherHIGHMARK
PA1412558OtherHIGHMARK
PA226129OtherHEALTH ASSURANCE
PA3425243OtherAETNA
PAP00098004OtherMEDICARE RAILROAD
PA1412558OtherHIGHMARK