Healthcare Provider Details
I. General information
NPI: 1932644200
Provider Name (Legal Business Name): ALLY PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/22/2016
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2089 E HIGH ST STE A
POTTSTOWN PA
19464-3269
US
IV. Provider business mailing address
2089 E HIGH ST STE A
POTTSTOWN PA
19464-3269
US
V. Phone/Fax
- Phone: 484-624-5594
- Fax: 484-644-3933
- Phone: 484-624-5594
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | PT-013254-L |
| License Number State | PA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
ROBERT
EPTING
Title or Position: OWNER
Credential:
Phone: 484-919-7027