Provider Demographics
NPI:1174858658
Name:SPEHAR, BORUT (PT)
Entity type:Individual
Prefix:
First Name:BORUT
Middle Name:
Last Name:SPEHAR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 STONECREST DR
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15530-6829
Mailing Address - Country:US
Mailing Address - Phone:412-334-5209
Mailing Address - Fax:
Practice Address - Street 1:286 STONECREST DR
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:PA
Practice Address - Zip Code:15530-6829
Practice Address - Country:US
Practice Address - Phone:412-334-5209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017655225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist