Provider Demographics
NPI:1881729283
Name:CIRAULA, JEAN MARIE (PT)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:MARIE
Last Name:CIRAULA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 WINDSOR CT
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-3216
Mailing Address - Country:US
Mailing Address - Phone:724-452-7082
Mailing Address - Fax:
Practice Address - Street 1:400 W CULVERT ST
Practice Address - Street 2:
Practice Address - City:ZELIENOPLE
Practice Address - State:PA
Practice Address - Zip Code:16063-1580
Practice Address - Country:US
Practice Address - Phone:724-452-1603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006169L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist