Provider Demographics
NPI:1053946384
Name:BE ACTIVE PHYSICAL THERAPY AND WELLNESS
Entity type:Organization
Organization Name:BE ACTIVE PHYSICAL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BONSRA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:724-986-3778
Mailing Address - Street 1:116 MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-3730
Mailing Address - Country:US
Mailing Address - Phone:724-986-3778
Mailing Address - Fax:
Practice Address - Street 1:938 4TH AVE
Practice Address - Street 2:
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-1602
Practice Address - Country:US
Practice Address - Phone:724-986-3778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty