Provider Demographics
NPI:1548822166
Name:EPOCH PHYSICAL THERAPY
Entity type:Organization
Organization Name:EPOCH PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:412-654-3212
Mailing Address - Street 1:PO BOX 101
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-0101
Mailing Address - Country:US
Mailing Address - Phone:833-888-7868
Mailing Address - Fax:833-888-7868
Practice Address - Street 1:2245 ROUTE 130
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:NJ
Practice Address - Zip Code:08810-0881
Practice Address - Country:US
Practice Address - Phone:412-654-3212
Practice Address - Fax:833-888-7868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty