Healthcare Provider Details

I. General information

NPI: 1114915725
Provider Name (Legal Business Name): LEHIGH VALLEY PHYSICAL THERAPY CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 S BEST AVE
WALNUTPORT PA
18088-1217
US

IV. Provider business mailing address

421 S BEST AVE
WALNUTPORT PA
18088-1217
US

V. Phone/Fax

Practice location:
  • Phone: 610-760-1520
  • Fax:
Mailing address:
  • Phone: 610-760-1520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JEANETTE HAMELL
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 610-760-1520