Healthcare Provider Details

I. General information

NPI: 1447424064
Provider Name (Legal Business Name): ORTHOPEDIC AND SPORTS PHYSICAL THERAPY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9337 KREWSTOWN ROAD
PHILADELPHIA PA
19115
US

IV. Provider business mailing address

420 BAINBRIDGE ST
PHILADELPHIA PA
19147-1568
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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