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General NPI Number Information
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NPI Number | 1083011084
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Entity Type | Organization
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Legal Business Name | DONNEFIT PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 11/19/2014
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Last Update Date | 12/07/2022
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Provider Practice Location Address
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Address Line | 6031 RISING SUN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-6008
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Country | US
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Telephone | 267-538-5011
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Fax |
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Provider Business Mailing Address
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Address Line | 6031 RISING SUN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-6008
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Country | US
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Telephone | 267-538-5011
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JANE NGUYEN
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Credential | PT, DPT
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Telephone | 215-266-9652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT018595
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License Number State | PA
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