Provider Demographics
NPI:1598590671
Name:MADE NEW PHYSICAL THERAPY, CO.
Entity type:Organization
Organization Name:MADE NEW PHYSICAL THERAPY, CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:717-926-5245
Mailing Address - Street 1:809 DORSEA RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2200
Mailing Address - Country:US
Mailing Address - Phone:717-926-5245
Mailing Address - Fax:
Practice Address - Street 1:37 W MILLPORT RD
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-9324
Practice Address - Country:US
Practice Address - Phone:717-568-2023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy