Provider Demographics
NPI:1518778612
Name:T3 REHAB AND PERFORMANCE LLC TRENTON WOOLCOCK SOLE MBR
Entity type:Organization
Organization Name:T3 REHAB AND PERFORMANCE LLC TRENTON WOOLCOCK SOLE MBR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TRENTON
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOLCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-419-3289
Mailing Address - Street 1:138 LINVIC DR
Mailing Address - Street 2:
Mailing Address - City:MUNCY
Mailing Address - State:PA
Mailing Address - Zip Code:17756-8806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:396 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17702-7409
Practice Address - Country:US
Practice Address - Phone:570-419-3289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy