Healthcare Provider Details

I. General information

NPI: 1275449530
Provider Name (Legal Business Name): VINCENT LOMBARDO DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 MCFARLAN RD STE 100
KENNETT SQUARE PA
19348-2477
US

IV. Provider business mailing address

18444 N 25TH AVE STE 310
PHOENIX AZ
85023-1266
US

V. Phone/Fax

Practice location:
  • Phone: 610-925-4901
  • Fax: 833-941-3871
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT034390
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: