| NPI | 1104169143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE BUDDY Credentialing Coordinator 610-359-5671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2022-01-31 |