Organization
IMPACT PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CURTIS CARDMAN MPT (OWNER)
(814) 881-9193
Entity
Organization
Contact information
Practice address
5415 W LAKE RD, ERIE, PA 16505-2841
(814) 838-2133
(814) 838-2355
Mailing address
5415 W LAKE RD, ERIE, PA 16505-2841
(814) 838-2133
(814) 838-2355
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
PT006544L
PA
174400000X
Specialist
Primary
PT008392L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023738100001
—
PA
01
—
DR7707
RAILROAD MEDICARE
PA
Enumeration date
08/06/2009
Last updated
09/18/2014
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