Healthcare Provider Details
I. General information
NPI: 1306634084
Provider Name (Legal Business Name): PHYSIOWAVE ELECTRODIAGNOSTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/30/2025
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 TOWN CTR TREATMENT ROOM 3
NEW BRITAIN PA
18901-6004
US
IV. Provider business mailing address
420 CHARIOT CT
CHALFONT PA
18914-3773
US
V. Phone/Fax
- Phone: 267-337-4139
- Fax:
- Phone: 267-337-4139
- Fax: 267-337-4139
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 293D00000X |
| Taxonomy | Physiological Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NEIL
THOMAS
BOYLE
Title or Position: OWNER
Credential: DPT
Phone: 267-337-4139