Provider Demographics
NPI:1215529631
Name:SOVA, THEODORE S III (DPT)
Entity type:Individual
Prefix:
First Name:THEODORE
Middle Name:S
Last Name:SOVA
Suffix:III
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 W CRAWFORD AVE
Mailing Address - Street 2:
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425-3526
Mailing Address - Country:US
Mailing Address - Phone:724-628-7288
Mailing Address - Fax:
Practice Address - Street 1:171 W CRAWFORD AVE
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-3526
Practice Address - Country:US
Practice Address - Phone:724-628-7288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist