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General NPI Number Information
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NPI Number | 1114015286
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Entity Type | Individual
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Provider Name | CATHERINE RUDOLPH PT
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 525 W CHESTER PIKE
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City | HAVERTOWN
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State | PA
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Zip | 19083-4539
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Country | US
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Telephone | 610-449-8400
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Fax | 610-449-6392
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Provider Business Mailing Address
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Address Line | 213 RODMOR RD
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City | HAVERTOWN
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State | PA
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Zip | 19083-4924
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PT015017
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License Number State | PA
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