| Doctor Name: | MICHELLE L MEDIATE |
| NPI Number: | 1114213808 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | PT021111 |
| Business Practice Address: | 1985 Lincoln Way Rainbow Village Shopping Center White Oak, PA - 151312418 |
| Business Phone Number: | 4126722352 |
| Business Fax Number: | 4126722657 |
| Mailing Address: | 625 Lincoln Ave, Ste 107 Professional Plaza CHARLEROI |
| State: | PA |
| Postal Code: | 150222451 |
| Phone Number: | 7244831673 |
| Fax Number: | 7244830290 |
| NPI Enumeration Date: | 06/22/2011 |
| NPI Last Update Date: | 06/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT021111 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |