Organization
BOYLE ASSOCIATES PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STANLEY T PETRICK MSPT (CLINICAL SUPERVISOR)
(570) 455-7108
Entity
Organization
Contact information
Practice address
1201B N CHURCH ST, SUITE 307, HAZLE TOWNSHIP, PA 18202-1453
(570) 455-7108
(570) 455-8835
Mailing address
1201B N CHURCH ST, STE 307, HAZLE TOWNSHIP, PA 18202-1453
(570) 455-7108
(570) 455-8835
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1908196
BLUE SHIELD
PA
01
—
50007032
CAPITAL BLUE CROSS
PA
Enumeration date
04/08/2006
Last updated
07/27/2010
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