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General NPI Number Information
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NPI Number | 1104880590
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Entity Type | Organization
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Legal Business Name | PENN THERAPY ASSOCIATES, INC.
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 2010 W CHESTER PIKE SUITE 450
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City | HAVERTOWN
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State | PA
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Zip | 19083-2700
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Country | US
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Telephone | 610-853-0508
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Fax | 610-853-3837
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Provider Business Mailing Address
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Address Line | 2010 W CHESTER PIKE SUITE 450
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City | HAVERTOWN
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State | PA
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Zip | 19083-2700
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Country | US
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Telephone | 610-853-0508
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Fax | 610-853-3837
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MARK E. REITZ
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Credential | PT
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Telephone | 610-853-0508
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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 | PT003694L
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License Number State | PA
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