Provider Demographics
NPI:1326222365
Name:TARR, RANDY (DPT)
Entity type:Individual
Prefix:
First Name:RANDY
Middle Name:
Last Name:TARR
Suffix:
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 1:3355 W CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-8302
Mailing Address - Country:US
Mailing Address - Phone:724-222-4254
Mailing Address - Fax:724-222-7465
Practice Address - Street 1:3355 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-8302
Practice Address - Country:US
Practice Address - Phone:724-206-0927
Practice Address - Fax:724-206-0927
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018978225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist