Organization
ELIZABETHTOWN PHYSICAL THERAPY PSC
Active
Other names
KORT Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL E TARVIN (VICE PRESIDENT)
(717) 975-4503
Entity
Organization
Contact information
Practice address
815 FAIRWAY DR, SUITE C, BRANDENBURG, KY 40108
(270) 422-3366
(270) 422-3378
Mailing address
4716 OLD GETTYSBURG RD, LEGAL DEPARTMENT, MECHANICSBURG, PA 17055
(717) 975-4503
(717) 975-9981
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8900
PTPP
KY
Enumeration date
08/04/2005
Last updated
03/11/2008
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