Provider Demographics
NPI:1992875272
Name:BIERANOSKI, JUSTIN L (PT)
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:L
Last Name:BIERANOSKI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 DODD DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-9529
Mailing Address - Country:US
Mailing Address - Phone:724-681-2570
Mailing Address - Fax:724-833-9449
Practice Address - Street 1:107 CURRY RD
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-3415
Practice Address - Country:US
Practice Address - Phone:724-627-4074
Practice Address - Fax:724-833-9449
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018133225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist