Provider Demographics
NPI:1881439552
Name:WARRIOR SPORTS REHAB LLC
Entity type:Organization
Organization Name:WARRIOR SPORTS REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGAHA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:814-626-8632
Mailing Address - Street 1:3316 5TH AVENUE
Mailing Address - Street 2:STE 300
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602
Mailing Address - Country:US
Mailing Address - Phone:814-626-8632
Mailing Address - Fax:
Practice Address - Street 1:3316 5TH AVENUE
Practice Address - Street 2:STE 300
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602
Practice Address - Country:US
Practice Address - Phone:814-626-8632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty