Healthcare Provider Details

I. General information

NPI: 1598690513
Provider Name (Legal Business Name): HAGAN PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 GLENSIDE AVE STE 3
WYNCOTE PA
19095-1221
US

IV. Provider business mailing address

29 SPRINGHOUSE LN
GLENSIDE PA
19038-3919
US

V. Phone/Fax

Practice location:
  • Phone: 267-767-3474
  • Fax:
Mailing address:
  • Phone:
  • 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: DR. JOHN HAGAN
Title or Position: OWNER
Credential: DPT
Phone: 267-767-3474