Provider Demographics
NPI:1780612440
Name:TWINTIER PHYSICAL REHAB, LLC
Entity type:Organization
Organization Name:TWINTIER PHYSICAL REHAB, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING EMPLOYEE/PHYSICAL THERAPIS
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTTERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-368-4630
Mailing Address - Street 1:665 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3941
Mailing Address - Country:US
Mailing Address - Phone:724-465-3496
Mailing Address - Fax:724-465-3726
Practice Address - Street 1:24 W WASHINGTON ST
Practice Address - Street 2:SUITE B
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-1280
Practice Address - Country:US
Practice Address - Phone:814-368-4630
Practice Address - Fax:814-368-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy