Mattocks, Larry Wayne
Mattocks, Larry Wayne is an individual health care provider with primary practice located at 1599 North Hermitage Rd , Hermitage PA 16148. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Mattocks, Larry Wayne can be contacted via phone (724) 962-7920.Contact Information
Primary practice address
1599 North Hermitage Rd
Hermitage PA 16148
Phone: (724) 962-7920
Fax: (724) 962-6029
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT007303L | Pennsylvania |
Profile Details
| NPI number | 1588644546 |
|---|---|
| LBN Legal business name | Mattocks, Larry Wayne |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 18th, 2006 |
| Last updated | May 19th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588644546 | NPPES |
| Pennsylvania | MEDICAID | 1016368810002 | |
| Pennsylvania | Other | 104392 | |
| Pennsylvania | Other | 220033 | |
| Pennsylvania | Other | 5160144 | |
| Pennsylvania | Other | 548783 | |
| Pennsylvania | Other | 724159 | |
| Pennsylvania | Other | 025221 | |
| Pennsylvania | Other | 1983093 | |
| Pennsylvania | Other | 118111 | |
| Pennsylvania | Other | 417718 | |
| Pennsylvania | Other | 579C |
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