MEDICARE: JCR PHYSICAL MEDICINE GROUP

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	PT004092L	PA

General Provider Information

NPI Number	:	1528450244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JCR PHYSICAL MEDICINE GROUP

Provider Business Mailing Address
First Line	:	PO BOX 755
Second Line	:
City	:	AMBLER
State	:	PA
Zip	:	19002-0755
Country	:	US
Telephone Number	:	215-836-8500
Fax Number	:	215-836-8503

Provider Business Practice Location Address
First Line	:	3000 N 22ND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19132-1501
Country	:	US
Telephone Number	:	215-223-6549
Fax Number	:	215-223-3670

Authorized Official
Title or Position	:	PARTNER
Name	:	JENNIFER GUARNACCIA
Credential	:
Telephone Number	:	215-223-6548

Provider Enumeration Date	:	03/04/2015
Last Update Date	:	03/04/2015

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Directions to “JCR PHYSICAL MEDICINE GROUP ” Practice Location

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