Healthcare Provider Details

I. General information

NPI: 1326028887
Provider Name (Legal Business Name): PARRY PT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 ROUTE 113
SOUDERTON PA
18964-1000
US

IV. Provider business mailing address

723 ROUTE 113
SOUDERTON PA
18964-1000
US

V. Phone/Fax

Practice location:
  • Phone: 215-538-1999
  • Fax:
Mailing address:
  • Phone: 215-538-1999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DALE YAKE
Title or Position: CEO
Credential:
Phone: 678-981-3543