Healthcare Provider Details

I. General information

NPI: 1255381448
Provider Name (Legal Business Name): ORTHOPEDIC AND SPORTS PHYSICAL THERAPY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 BUSTLETON AVE SUITE 204
PHILADELPHIA PA
19152-3328
US

IV. Provider business mailing address

420 BAINBRIDGE ST
PHILADELPHIA PA
19147-1568
US

V. Phone/Fax

Practice location:
  • Phone: 215-335-7400
  • Fax: 215-335-7404
Mailing address:
  • Phone: 215-629-3837
  • Fax: 215-629-5531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JEFFREY ROBERT OSTROWSKI
Title or Position: CEO
Credential: PT
Phone: 215-629-3837