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General NPI Number Information
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NPI Number | 1194994228
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Entity Type | Organization
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Legal Business Name | PLAZA PHYSICAL THERAPY
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Dates
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Enumeration Date | 02/22/2008
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Last Update Date | 02/22/2008
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Provider Practice Location Address
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Address Line | 339-343 EAST STREET ROAD STERNER'S MILL OFFICE COMPLEX
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City | TREVOSE
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State | PA
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Zip | 19053
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Country | US
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Telephone | 267-574-8110
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Fax | 267-574-8111
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Provider Business Mailing Address
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Address Line | 339-343 EAST STREET ROAD STERNER'S MILL OFFICE COMPLEX
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City | TREVOSE
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State | PA
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Zip | 19053
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Country | US
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Telephone | 267-574-8110
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Fax | 267-574-8111
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. BRIAN J KIRBY
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Credential | MSPT
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Telephone | 267-574-8110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT013564L
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License Number State | PA
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