Provider Demographics
NPI:1487990875
Name:SHOCH PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:SHOCH PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SHOCH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:570-286-7462
Mailing Address - Street 1:309 N 5TH ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:SUNBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17801-2000
Mailing Address - Country:US
Mailing Address - Phone:570-286-7462
Mailing Address - Fax:570-286-1117
Practice Address - Street 1:309 N 5TH ST
Practice Address - Street 2:SUITE E
Practice Address - City:SUNBURY
Practice Address - State:PA
Practice Address - Zip Code:17801-2000
Practice Address - Country:US
Practice Address - Phone:570-286-7462
Practice Address - Fax:570-286-1117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011816L261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy