Basic Information
| Provider Information | |||||||||
| NPI: | 1548660319 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BETH A CARR PT, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 64 | ||||||||
| Address2: | 845 WATER STREET | ||||||||
| City: | NORTHUMBERLAND | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178570064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704733912 | ||||||||
| FaxNumber: | 5704738731 | ||||||||
| Practice Location | |||||||||
| Address1: | 845 WATER ST | ||||||||
| Address2: | |||||||||
| City: | NORTHUMBERLAND | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178571243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704733912 | ||||||||
| FaxNumber: | 5704738731 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2014 | ||||||||
| LastUpdateDate: | 08/29/2014 | ||||||||
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| AuthorizedOfficialLastName: | CARR | ||||||||
| AuthorizedOfficialFirstName: | BETH | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5704733912 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT, DPT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | PT023661 | PA | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.