Healthcare Provider Details

I. General information

NPI: 1285665612
Provider Name (Legal Business Name): AARON EBLING PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9475 ROOSEVELT BLVD
PHILADELPHIA PA
19114-2212
US

IV. Provider business mailing address

2001 BUTTERFIELD RD STE 1600
DOWNERS GROVE IL
60515-1211
US

V. Phone/Fax

Practice location:
  • Phone: 215-464-6200
  • Fax: 215-464-9834
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT018212
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: