Healthcare Provider Details

I. General information

NPI: 1811764913
Provider Name (Legal Business Name): COLUMBRINA ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2023
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 LANTERN DR STE 1
DOYLESTOWN PA
18901-1902
US

IV. Provider business mailing address

1470 RIVER RD
NEW HOPE PA
18938-9265
US

V. Phone/Fax

Practice location:
  • Phone: 412-428-5223
  • Fax:
Mailing address:
  • Phone: 412-428-5223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JASON YAGER
Title or Position: OWNER
Credential:
Phone: 609-475-5995