Provider Demographics
NPI:1366081168
Name:KUZMA PHYSICAL THERAPY AND SPORTS MEDICINE LLC
Entity type:Organization
Organization Name:KUZMA PHYSICAL THERAPY AND SPORTS MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:724-458-9473
Mailing Address - Street 1:46 ROSEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16127-4550
Mailing Address - Country:US
Mailing Address - Phone:724-458-9473
Mailing Address - Fax:724-458-6378
Practice Address - Street 1:991 ROUTE 19 N STE E
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:PA
Practice Address - Zip Code:16441-9739
Practice Address - Country:US
Practice Address - Phone:814-796-3400
Practice Address - Fax:814-796-8533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy