Healthcare Provider Details

I. General information

NPI: 1295101236
Provider Name (Legal Business Name): FAITHFUL PHYSICAL THERAPY CONCEPTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2015
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1738 W CHELTENHAM AVE
PHILADELPHIA PA
19126-1546
US

IV. Provider business mailing address

1738 W CHELTENHAM AVE
PHILADELPHIA PA
19126-1546
US

V. Phone/Fax

Practice location:
  • Phone: 215-548-3390
  • Fax: 215-549-8998
Mailing address:
  • Phone: 215-548-3390
  • Fax: 215-549-8998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOHN J BOWDEN JR.
Title or Position: OWNER
Credential:
Phone: 215-886-4000