Healthcare Provider Details
I. General information
NPI: 1265563076
Provider Name (Legal Business Name): REGIONAL PHYSICAL THERAPY ASSCOIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/07/2007
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
637 S 52ND ST
PHILADELPHIA PA
19143-2630
US
IV. Provider business mailing address
PO BOX 526
NARBERTH PA
19072-0526
US
V. Phone/Fax
- Phone: 215-471-0329
- Fax: 215-471-9087
- Phone: 610-649-7885
- Fax: 610-649-9291
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | PT003581L |
| License Number State | PA |
VIII. Authorized Official
Name: MR.
THOMAS
ANTHONY
KANE
Title or Position: PRESIDENT
Credential: PT
Phone: 610-649-7885