Healthcare Provider Details

I. General information

NPI: 1396785119
Provider Name (Legal Business Name): MARY JOY FRANCIS PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 12/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 BEAR CORBITT RD
BEAR DE
19701-1323
US

IV. Provider business mailing address

17 N COLTS NECK WAY
HOCKESSIN DE
19707-9789
US

V. Phone/Fax

Practice location:
  • Phone: 302-454-2400
  • Fax: 302-424-2400
Mailing address:
  • Phone: 610-764-7146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberJ2-0000584
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: