Michelle L Dickson, DPT
Individual provider Active NPI Physical Therapist · Clarks Summit, PA
NPI 1932437175 · NPPES record last updated Jan 17, 2013
Key facts
- NPI
- 1932437175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT020233 (PA)
- Practice address
- 115 E Grove St
Clarks Summit, PA 18411-1773 - Phone
- (570) 586-1188
- Fax
- (570) 585-7323
- NPI assigned
- Nov 30, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT020233 | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pivot Physical Therapy of Pennsylvania, LLC | Physical Therapist | Past |
Accepting new patients |
| Procare Physical Therapy Inc | Physical Therapist | Past | Accepting new patients |
| Body Dynamic | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT020233 | PA | Yes |
Addresses
Primary practice location
115 E Grove St
Clarks Summit, PA 18411-1773
Mailing address
115 E Grove St
Clarks Summit, PA 18411-1773
Phone (570) 586-1188
Other providers in Clarks Summit, PA
- Charles W Dennis
- Michael F Desarno
- Christine Desousa
- Thomas Ernest Di Matteo
- Tracy Lee Di Mattia
- Virginia L Dikeman
- Nicole Rene Dixon
- Kathleen Doherty
- Martin Andrew Donahue
- William Francis Dougherty
All providers in Clarks Summit, PA · Physical Therapist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.