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General NPI Number Information
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NPI Number | 1134992852
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Entity Type | Individual
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Provider Name | MITCHELL SALVATORE MCLEOD PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 11/03/2023
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 6120 WOODLAND AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19142-3200
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Country | US
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Telephone | 215-727-2765
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Fax |
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Provider Business Mailing Address
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Address Line | 147 KNOLLWOOD CT
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City | ASTON
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State | PA
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Zip | 19014-1260
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Country | US
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Telephone | 215-771-1352
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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 | PT031908
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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