| NPI | 1215154711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH REID VAN DEMARK President 215-752-2159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT002679-L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00109000) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |