Healthcare Provider Details

I. General information

NPI: 1932389657
Provider Name (Legal Business Name): MAURICE P RICH RPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2007
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1461 ROTHLEY AVE
WILLOW GROVE PA
19090-4817
US

IV. Provider business mailing address

1461 ROTHLEY AVE
WILLOW GROVE PA
19090-4817
US

V. Phone/Fax

Practice location:
  • Phone: 215-439-5563
  • Fax:
Mailing address:
  • Phone: 215-439-5563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT003763L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: