Healthcare Provider Details

I. General information

NPI: 1962713180
Provider Name (Legal Business Name): EFT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 06/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 2ND STREET PIKE
SOUTHAMPTON PA
18966-3814
US

IV. Provider business mailing address

408 2ND STREET PIKE
SOUTHAMPTON PA
18966-3814
US

V. Phone/Fax

Practice location:
  • Phone: 215-830-9991
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number
License Number State

VIII. Authorized Official

Name: BRIAN WHEELER
Title or Position: CEO
Credential:
Phone: 215-830-9991