Provider Demographics
NPI:1114274909
Name:FARABAUGH, TRISTA (DPT)
Entity type:Individual
Prefix:
First Name:TRISTA
Middle Name:
Last Name:FARABAUGH
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:TRISTA
Other - Middle Name:
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 TRINITY DR E STE 110
Mailing Address - Street 2:
Mailing Address - City:DILLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17019-8522
Mailing Address - Country:US
Mailing Address - Phone:717-432-7719
Mailing Address - Fax:717-432-7531
Practice Address - Street 1:10 SPRINGS AVE
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-1724
Practice Address - Country:US
Practice Address - Phone:717-334-6834
Practice Address - Fax:717-334-3923
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305207567225100000X
PAPT023514225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist