Healthcare Provider Details

I. General information

NPI: 1275887457
Provider Name (Legal Business Name): EMC REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2012
Last Update Date: 11/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 W CHESTER PIKE STE 407
HAVERTOWN PA
19083-2739
US

IV. Provider business mailing address

115 CROSSHILL RD
WYNNEWOOD PA
19096-3511
US

V. Phone/Fax

Practice location:
  • Phone: 215-200-5891
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: XIAOXI HE
Title or Position: MANAGER
Credential:
Phone: 215-200-5891