Mottillo, Mark A
Mottillo, Mark A is an individual health care provider with primary practice located at 4247 W Ridge Rd Ste 104 , Erie PA 16506-1746. 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. Mottillo, Mark A can be contacted via phone (814) 833-7249.Contact Information
Primary practice address
4247 W Ridge Rd Ste 104
Erie PA 16506-1746
Phone: (814) 833-7249
Fax: (814) 838-2661
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT007800L | Pennsylvania |
Profile Details
| NPI number | 1598766024 |
|---|---|
| LBN Legal business name | Mottillo, Mark A |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 9th, 2005 |
| Last updated | Sep 15th, 2023 - about 2 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 | 1598766024 | NPPES |
| Pennsylvania | Other | V0843B | UPMC |
| Pennsylvania | Other | 85873 | UPMC |
| Pennsylvania | MEDICAID | 001689240005 | UPMC |
| Pennsylvania | Other | 5622458 | UPMC |
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