Organization Name: | MOUNTAIN RIVER PHYSICAL THERAPY LLC |
NPI Number: | 1710135306 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BURTON REED (OWNER/THERAPIST) |
Mailing Address: | 5479 Pottsville Pike Suite 200 Leesport |
State: | PA US |
Postal Code: | 195338650 |
Phone Number: | 6109266778 |
Fax Number: | 6109267200 |
NPI Enumeration Date: | 09/08/2008 |
NPI Last Update Date: | 05/27/2016 |
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: |