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Organization
WATERFORD PHYSICAL THERAPY, INC.
Active
Organization
WATERFORD PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY LEE WAITE (PRESIDENT)
(814) 796-3400
Entity
Organization
Contact information
Practice address
991 ROUTE 19 N STE E, WATERFORD, PA 16441-9739
(814) 796-3400
(814) 796-8533
Mailing address
991 ROUTE 19 N STE E, WATERFORD, PA 16441-9739
(814) 796-3400
(814) 796-8533
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017340310001
—
PA
Enumeration date
07/30/2006
Last updated
04/21/2011
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