Basic Information
| Provider Information | |||||||||
| NPI: | 1609835651 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BETH A. CARR PT INC | ||||||||
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| OtherOrganizationName: | CARR PHYSICAL THERAPY CENTER | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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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: | 5404738731 | ||||||||
| Practice Location | |||||||||
| Address1: | 845 WATER ST | ||||||||
| Address2: | |||||||||
| City: | NORTHUMBERLAND | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178571243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704733912 | ||||||||
| FaxNumber: | 5404738731 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2006 | ||||||||
| LastUpdateDate: | 03/25/2013 | ||||||||
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| AuthorizedOfficialLastName: | COMFORT | ||||||||
| AuthorizedOfficialFirstName: | MARY | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5704733912 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.