Provider Demographics
NPI:1073828364
Name:RODIO, NICHOLAS J (DPT)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:J
Last Name:RODIO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24569 ROUTE 6
Mailing Address - Street 2:SUITE C
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848-5254
Mailing Address - Country:US
Mailing Address - Phone:570-265-1111
Mailing Address - Fax:570-265-7134
Practice Address - Street 1:7731 ROUTE 6
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:PA
Practice Address - Zip Code:16947-9253
Practice Address - Country:US
Practice Address - Phone:570-297-2774
Practice Address - Fax:570-297-3547
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT020891225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist