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General NPI Number Information
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NPI Number | 1326360058
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Entity Type | Organization
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Legal Business Name | MX PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 8601 STENTON AVE
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City | WYNDMOOR
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State | PA
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Zip | 19038-8312
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Country | US
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Telephone | 215-261-7204
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Fax |
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Provider Business Mailing Address
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Address Line | 8601 STENTON AVE
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City | WYNDMOOR
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State | PA
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Zip | 19038-8312
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Country | US
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Telephone | 215-261-7204
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. EDWARD R. MIERSCH
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Credential |
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Telephone | 610-322-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State | NULL
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