Provider Demographics
NPI:1538799796
Name:SIRONA THERAPY P.C.
Entity type:Organization
Organization Name:SIRONA THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, MPT
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOUTTE
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:814-528-7954
Mailing Address - Street 1:220 W PLUM ST STE 335
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-2167
Mailing Address - Country:US
Mailing Address - Phone:814-528-7954
Mailing Address - Fax:
Practice Address - Street 1:220 W PLUM ST STE 335
Practice Address - Street 2:
Practice Address - City:EDINBORO
Practice Address - State:PA
Practice Address - Zip Code:16412-2167
Practice Address - Country:US
Practice Address - Phone:814-528-7954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy