Organization
INNOVATIVE PEDIATRIC THERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN MITRENKO OTR/L (OWNER)
(570) 266-5181
Entity
Organization
Contact information
Practice address
713 BRIDGE ST STE 23, SELINSGROVE, PA 17870-1250
(570) 266-5181
Mailing address
350 S MARKET ST, SELINSGROVE, PA 17870-1816
(508) 269-2747
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/24/2020
Last updated
09/18/2020
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