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General NPI Number Information
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NPI Number | 1275599409
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Entity Type | Organization
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Legal Business Name | TRACY HORTER PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 919 CONESTOGA RD BLDG 3 STE 114
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City | ROSEMONT
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State | PA
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Zip | 19010-1352
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Country | US
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Telephone | 610-527-0178
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Fax | 610-527-5770
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Provider Business Mailing Address
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Address Line | 919 CONESTOGA RD BLDG 3 STE 114
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City | ROSEMONT
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State | PA
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Zip | 19010-1352
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Country | US
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Telephone | 610-527-0178
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Fax | 610-527-5770
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Authorized Official
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Title or Position | OWNER
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Name | MS. TRACY S HORTER
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Credential | PT
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Telephone | 610-527-0178
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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 | PT002487L
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License Number State | PA
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