Healthcare Provider Details

I. General information

NPI: 1760017214
Provider Name (Legal Business Name): BRITTANY GUMERMAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2020
Last Update Date: 03/05/2020
Certification Date: 03/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2285 CROSS RD
GLENSIDE PA
19038-5009
US

IV. Provider business mailing address

730 S BROAD ST
LANSDALE PA
19446-5211
US

V. Phone/Fax

Practice location:
  • Phone: 215-887-2001
  • Fax: 215-887-8911
Mailing address:
  • Phone: 267-663-7767
  • Fax: 267-222-8158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT028434
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: