MEDICARE: NORTHWEST PHYSICAL THERAPY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT002925L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518950112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST PHYSICAL THERAPY, INC.

Provider Business Mailing Address
First Line	:	8200 FLOURTOWN AVE
Second Line	:	SUITE 11
City	:	WYNDMOOR
State	:	PA
Zip	:	19038-7976
Country	:	US
Telephone Number	:	215-233-5572
Fax Number	:	215-233-5584

Provider Business Practice Location Address
First Line	:	8200 FLOURTOWN AVE
Second Line	:	SUITE 11
City	:	WYNDMOOR
State	:	PA
Zip	:	19038-7976
Country	:	US
Telephone Number	:	215-233-5572
Fax Number	:	215-233-5584

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JOHN C. LOCKARD
Credential	:	P.T., O.C.S.
Telephone Number	:	215-233-5572

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	03/09/2016

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8200 FLOURTOWN AVE , SUITE 11
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1184674228 — GREGORY J. TRAMUTA MD PC
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1023069135 — DR. GREGORY JOSEPH TRAMUTA M.D.
Practice Location Address:

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Directions to “NORTHWEST PHYSICAL THERAPY, INC. ” Practice Location

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