Healthcare Provider Details

I. General information

NPI: 1063448793
Provider Name (Legal Business Name): ADVANCED PHYSICAL THERAPY ASSOCIATES, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

934 MONTGOMERY AVE
NARBERTH PA
19072-1913
US

IV. Provider business mailing address

934 MONTGOMERY AVE
NARBERTH PA
19072-1913
US

V. Phone/Fax

Practice location:
  • Phone: 610-664-3400
  • Fax: 610-664-8482
Mailing address:
  • Phone: 610-664-3400
  • Fax: 610-664-8482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DAVID LISAN
Title or Position: OWNER
Credential: RPT
Phone: 610-664-3400