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Organization

PATRIOT PHYSICAL THERAPY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GARY BORNAK MPT (OWNER/PT)
(412) 462-2330
Entity
Organization

Contact information

Practice address
2279B MAIN STREET, MUNHALL, PA 15120
(412) 462-1191
(412) 462-1182
Mailing address
4609 EASY STREET, WEST MIFFLIN, PA 15122-1966
(412) 462-1191
(412) 462-1182

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
225100000X
Physical Therapist
261QP2000X
Physical Therapy Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DA9531
RAILROAD MEDICARE
PA
01
PT016751
PHYSICAL THERAPIST
PA
Enumeration date
04/17/2006
Last updated
11/26/2012
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