Provider Demographics
NPI:1780614453
Name:PT GROUP ACQUISITION LLC
Entity type:Organization
Organization Name:PT GROUP ACQUISITION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CORDIAL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:724-850-7587
Mailing Address - Street 1:438 PELLIS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7900
Mailing Address - Country:US
Mailing Address - Phone:724-850-7587
Mailing Address - Fax:724-850-9909
Practice Address - Street 1:520 PELLIS RD
Practice Address - Street 2:SUITE 1000
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4777
Practice Address - Country:US
Practice Address - Phone:724-850-7587
Practice Address - Fax:724-850-9909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA097559UY6Medicare ID - Type Unspecified
PA441422HLFMedicare ID - Type Unspecified