Justine Danielle Burrell, PT

Individual provider Active NPI Physical Therapist · Forest City, PA

NPI 1891924601 · NPPES record last updated Nov 2, 2010

Key facts

NPI
1891924601
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT020022 (PA)
Practice address
354 Main St
Forest City, PA 18421-1418
Phone
(570) 785-2018
Fax
(570) 785-2061
NPI assigned
Jul 14, 2009
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT020022PAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT020022 PA Yes

Addresses

Primary practice location

354 Main St
Forest City, PA 18421-1418

Mailing address

441 Marion St
Browndale, PA 18421-1228
Phone (570) 960-1782

Other providers in Forest City, PA

All providers in Forest City, PA · Physical Therapist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.