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NPI Code Detail

MEDICARE: GINA M VAUL MSPT

MEDICARE: GINA M VAUL MSPT
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
1225100000XPhysical TherapistPT 015384PA
2225100000XPhysical TherapistJ1-0001624DE

General Provider Information

NPI Number : 1922122712
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA M VAUL MSPT
Provider Business Mailing Address
First Line : 2633 ABINGTON RD
Second Line :
City : WILMINGTON
State : DE
Zip : 19810-1101
Country : US
Telephone Number : 302-475-6029
Fax Number :
Provider Business Practice Location Address
First Line : 2250 HICKORY RD
Second Line : SUITE 240
City : PLYMOUTH MEETING
State : PA
Zip : 19462-1047
Country : US
Telephone Number : 610-834-1122
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2007
Last Update Date : 07/08/2007

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