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General NPI Number Information
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NPI Number | 1114985074
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Entity Type | Individual
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Provider Name | JOHN THOMAS WATERS JR. PT
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Gender | Male
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2804 AUDUBON VILLAGE DR
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City | NORRISTOWN
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State | PA
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Zip | 19403-2262
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Country | US
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Telephone | 610-676-0411
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Fax | 610-676-0412
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Provider Business Mailing Address
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Address Line | 2804 AUDUBON VILLAGE DR
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City | NORRISTOWN
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State | PA
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Zip | 19403-2262
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Country | US
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Telephone | 610-676-0411
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Fax | 610-676-0412
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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 | PT007658L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT001779A
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License Number State | PA
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