Healthcare Provider Details

I. General information

NPI: 1215271259
Provider Name (Legal Business Name): ACUPUNCTURE PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 11/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 PHEASANT RUN
NEWTOWN PA
18940-1821
US

IV. Provider business mailing address

170 PHEASANT RUN
NEWTOWN PA
18940-1821
US

V. Phone/Fax

Practice location:
  • Phone: 215-630-5172
  • Fax: 215-579-7661
Mailing address:
  • Phone: 215-630-5172
  • Fax: 215-579-7661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberKOOOOO64L
License Number StatePA

VIII. Authorized Official

Name: DR. STEVEN M. PERTES
Title or Position: OWNER
Credential: M.S. L. AC., D. P.T.
Phone: 215-630-5172