Healthcare Provider Details

I. General information

NPI: 1023941267
Provider Name (Legal Business Name): AMANDA RAE MCGREAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 PERSHING AVE
COLLINGDALE PA
19023-4119
US

IV. Provider business mailing address

526 PERSHING AVE
COLLINGDALE PA
19023-4119
US

V. Phone/Fax

Practice location:
  • Phone: 484-620-7377
  • Fax: 484-620-7377
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTE013977
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: