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Organization

NACL PHYSICAL THERAPY SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RENEA MORTEL ALFONSO PHYSICAL THERAPIST (OWNER)
(412) 848-7219
Entity
Organization

Contact information

Practice address
4880 LIBRARY RD, BETHEL PARK, PA 15102-2946
(412) 848-7219
Mailing address
4880 LIBRARY RD, BETHEL PARK, PA 15102-2946
(412) 848-7219

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT0186663
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
229559
MEDICARE PTAN
PA
Enumeration date
12/05/2014
Last updated
12/19/2014
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