Spectrum Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT012634L Issued in PA

Legal business name

SPECTRUM THERAPY LLC

Practice address

RR 1 Box 1836
Stanley Lake Road
Friendsville, PA 18818-9620

Phone

(570) 553-1633

NPI assigned

May 9, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lauri F Bulkley

Title

Partner

Phone

(570) 553-1633

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226448000000",
    "number": "1285848184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 1836",
            "address_2": "STANLEY LAKE ROAD",
            "city": "FRIENDSVILLE",
            "state": "PA",
            "postal_code": "188189620",
            "telephone_number": "570-553-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 1836",
            "address_2": "STANLEY LAKE ROAD",
            "city": "FRIENDSVILLE",
            "state": "PA",
            "postal_code": "188189620",
            "telephone_number": "570-553-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2008-11-12",
        "status": "A",
        "authorized_official_last_name": "BULKLEY",
        "authorized_official_first_name": "LAURI",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "570-553-1633"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT012634L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Friendsville, PA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.