Healthcare Provider Details

I. General information

NPI: 1639177744
Provider Name (Legal Business Name): JOSEPH T. RUHL JR. PT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 WALNUT ST SUITE 210
PHILADELPHIA PA
19103-5313
US

IV. Provider business mailing address

420 BAINBRIDGE ST
PHILADELPHIA PA
19147-1568
US

V. Phone/Fax

Practice location:
  • Phone: 215-545-8717
  • Fax: 215-629-5531
Mailing address:
  • Phone: 215-629-3837
  • Fax: 215-629-1293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-006116-L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT-006116-L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT-006116-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: