Organization
LAUREL HIGHLANDS NEURO-REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY RUTLEDGE PHD (EXECUTIVE DIRECTOR)
(814) 629-4223
Entity
Organization
Contact information
Practice address
111A ROOSEVELT BOULEVARD, JOHNSTOWN, PA 15906
(814) 619-4223
(814) 539-0985
Mailing address
1086 FRANKLIN ST, JOHNSTOWN, PA 15905-4305
(814) 410-8330
(814) 410-8331
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
PS008498L
PA
Other
Enumeration date
01/19/2007
Last updated
07/23/2008
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