| Organization Name: | PENN NEUROMUSCULAR DIAGNOSTICS, LLC |
| NPI Number: | 1144574575 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS W ZAUCHA (PRESIDENT/OWNER) |
| Mailing Address: | 900 Bryan St Suite 4 Huntingdon |
| State: | PA US |
| Postal Code: | 166522413 |
| Phone Number: | 7248018894 |
| Fax Number: | 7244656032 |
| NPI Enumeration Date: | 11/07/2012 |
| NPI Last Update Date: | 11/12/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |