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General NPI Number Information
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NPI Number | 1306634084
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Entity Type | Organization
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Legal Business Name | PHYSIOWAVE ELECTRODIAGNOSTICS PLLC
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 420 CHARIOT CT
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City | CHALFONT
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State | PA
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Zip | 18914-3773
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Country | US
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Telephone | 267-337-4139
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Fax | 267-337-4139
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Provider Business Mailing Address
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Address Line | 420 CHARIOT CT
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City | CHALFONT
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State | PA
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Zip | 18914-3773
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Country | US
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Telephone | 267-337-4139
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Fax | 267-337-4139
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Authorized Official
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Title or Position | OWNER
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Name | NEIL THOMAS BOYLE
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Credential | DPT
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Telephone | 267-337-4139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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