Provider Demographics
NPI:1548660319
Name:BETH A CARR PT, INC
Entity type:Organization
Organization Name:BETH A CARR PT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:570-473-3912
Mailing Address - Street 1:PO BOX 64
Mailing Address - Street 2:845 WATER STREET
Mailing Address - City:NORTHUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17857-0064
Mailing Address - Country:US
Mailing Address - Phone:570-473-3912
Mailing Address - Fax:570-473-8731
Practice Address - Street 1:845 WATER ST
Practice Address - Street 2:
Practice Address - City:NORTHUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17857-1243
Practice Address - Country:US
Practice Address - Phone:570-473-3912
Practice Address - Fax:570-473-8731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023661261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy