Provider Demographics
NPI:1528139839
Name:BYRNES, JANELL L (PTA)
Entity type:Individual
Prefix:MRS
First Name:JANELL
Middle Name:L
Last Name:BYRNES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:JANELL
Other - Middle Name:L
Other - Last Name:LOOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:604 PENN ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-1547
Mailing Address - Country:US
Mailing Address - Phone:814-695-9208
Mailing Address - Fax:
Practice Address - Street 1:1798 OLD ROUTE 220 N
Practice Address - Street 2:SUITE 103
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-8341
Practice Address - Country:US
Practice Address - Phone:814-696-3400
Practice Address - Fax:814-696-3402
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE007641225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant