Healthcare Provider Details

I. General information

NPI: 1114248556
Provider Name (Legal Business Name): PEDIATRIC THERAPY CENTER OF BUCKS COUNTY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 06/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 S EASTON RD
DOYLESTOWN PA
18901-2958
US

IV. Provider business mailing address

PO BOX 1203
DOYLESTOWN PA
18901-0079
US

V. Phone/Fax

Practice location:
  • Phone: 215-340-9555
  • Fax: 888-464-0969
Mailing address:
  • Phone: 215-340-9555
  • Fax: 888-464-0969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DR. DEBORAH STACK
Title or Position: PRESIDENT
Credential: PT, DPT, PCS
Phone: 215-340-9555