Provider Demographics
NPI:1861426389
Name:HOGAN, JOSHUA P (MPT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:P
Last Name:HOGAN
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TOMMYS CT
Mailing Address - Street 2:
Mailing Address - City:DRUMS
Mailing Address - State:PA
Mailing Address - Zip Code:18222-1007
Mailing Address - Country:US
Mailing Address - Phone:570-708-0221
Mailing Address - Fax:
Practice Address - Street 1:1 W BROAD ST
Practice Address - Street 2:SUITE 2
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-6407
Practice Address - Country:US
Practice Address - Phone:570-459-4559
Practice Address - Fax:570-459-4558
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012834L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist