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Organization
MODERN THERAPEUTICS INC
Active
Organization
MODERN THERAPEUTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY PHILLIP URILLO MPT (PRESIDENT)
(570) 453-0252
Entity
Organization
Contact information
Practice address
1109 W 15TH ST, HAZLETON, PA 18201
(570) 453-0252
(570) 453-0253
Mailing address
1109 W 15TH ST, HAZLETON, PA 18201
(570) 453-0252
(570) 453-0253
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1589647
BCBS
—
Enumeration date
05/10/2006
Last updated
02/08/2023
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