Justin D Eisenhofer, DPT, OCS, CSCS | |
5479 Pottsville Pike, Suite 200, Leesport, PA 19533-8650 | |
(610) 926-6778 | |
(610) 926-7200 |
Full Name | Justin D Eisenhofer |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 23 Years |
Location | 5479 Pottsville Pike, Leesport, Pennsylvania |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649284977 | NPI | - | NPPES |
2617663 | Medicaid | OH | |
3810003931 | Medicaid | WV | |
P00033898 | Other | RAILROAD MEDICARE | |
1022270250001 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 002261 (West Virginia) | Secondary |
225100000X | Physical Therapist | PT019473 (Pennsylvania) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
South Mountain Physical Therapy Llc | 4981771631 | 10 |
Provider Name | South Mountain Physical Therapy Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1932374113 PECOS PAC ID: 4981771631 Enrollment ID: O20080922000268 |
Mailing Address | Practice Location Address |
---|---|
Justin D Eisenhofer, DPT, OCS, CSCS 415 36th St, Suite 100, Parkersburg, WV 26101-1005 Ph: (304) 917-3660 | Justin D Eisenhofer, DPT, OCS, CSCS 5479 Pottsville Pike, Suite 200, Leesport, PA 19533-8650 Ph: (610) 926-6778 |
Gabrielle Freed, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5479 Pottsville Pike Ste 200, Leesport, PA 19533 Phone: 610-926-6778 | |
Kathryn E Mitten, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1011 Berks Road, Leesport, PA 19533 Phone: 610-376-4841 | |
Kristin Waldrop, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 291 Kindt Corner Rd, Leesport, PA 19533 Phone: 606-209-3185 | |
Kenneth Christopher Paz, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 5479 Pottsville Pike, Suite 200, Leesport, PA 19533 Phone: 610-926-6778 Fax: 610-926-7200 | |
Brady Fidler, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1001 James Dr Ste A14, Leesport, PA 19533 Phone: 484-671-2065 Fax: 484-671-2354 | |
Mr. Stephen Gregg Decker, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5479 Pottsville Pike, Suite 200, Leesport, PA 19533 Phone: 610-926-6778 Fax: 610-926-7200 | |
Dr. Steven Roughton, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1011 Berk Rd, Leesport, PA 19533 Phone: 610-376-4841 |