Provider Demographics
NPI:1063874907
Name:WITHROW, ATHENA (DPT)
Entity type:Individual
Prefix:
First Name:ATHENA
Middle Name:
Last Name:WITHROW
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ATHENA
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:252 LEXINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15135-3122
Mailing Address - Country:US
Mailing Address - Phone:412-559-0967
Mailing Address - Fax:
Practice Address - Street 1:159 WATERDAM RD STE 120
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-2576
Practice Address - Country:US
Practice Address - Phone:724-942-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-21
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT027533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist