Basic Information
| Provider Information | |||||||||
| NPI: | 1982666392 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DRAYER PHYSICAL THERAPY INSTITUTE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 152 E MARKET ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LEWISTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170442160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172424840 | ||||||||
| FaxNumber: | 7172424841 | ||||||||
| Practice Location | |||||||||
| Address1: | 152 E MARKET ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LEWISTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170442160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172424840 | ||||||||
| FaxNumber: | 7172424841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2006 | ||||||||
| LastUpdateDate: | 02/20/2012 | ||||||||
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| AuthorizedOfficialLastName: | DRAYER | ||||||||
| AuthorizedOfficialFirstName: | LUKE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7172202100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.