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General NPI Number Information
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NPI Number | 1548507098
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Entity Type | Individual
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Provider Name | MARIA ROWENA MEDILO RPT
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Gender | Female
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Dates
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Enumeration Date | 01/03/2013
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Last Update Date | 01/03/2013
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Provider Practice Location Address
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Address Line | 9000 TWIN SILO DR
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City | BLUE BELL
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State | PA
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Zip | 19422-4202
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Country | US
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Telephone | 215-661-1614
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Fax |
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Provider Business Mailing Address
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Address Line | 505 121ST PL NE # 2
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City | BELLEVUE
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State | WA
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Zip | 98005-3161
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Country | US
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Telephone | 206-708-0198
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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 | PT022502
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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 | J1-0002897
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License Number State | DE
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