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Organization
WEST SCHUYLKILL PHYSICAL THERAPY SERVICES, P.C.
Active
Organization
WEST SCHUYLKILL PHYSICAL THERAPY SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY C PUTALAVAGE (OFFICE MANAGER)
(570) 345-9966
Entity
Organization
Contact information
Practice address
8 OAK GROVE RD, SUITE 3, PINE GROVE, PA 17963
(570) 345-9966
(570) 345-9988
Mailing address
8 OAK GROVE RD, SUITE 3, PINE GROVE, PA 17963
(570) 345-9966
(570) 345-9988
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02858300
CAPITAL BLUE CROSS/CAIC
PA
01
—
033989
HIGHMARK MEDICARE SERVICES
PA
01
—
720544
PENNSYLVANIA BLUE SHIELD
PA
Enumeration date
07/12/2006
Last updated
04/23/2008
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