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General NPI Number Information
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NPI Number | 1598946493
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Entity Type | Organization
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Legal Business Name | BRANDYWINE PHYSICAL THERAPY SERVICES , INC.
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 1507 PHILADELPHIA PIKE APT A
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City | WILMINGTON
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State | DE
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Zip | 19809-1865
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Country | US
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Telephone | 302-798-9565
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Fax | 302-798-0792
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Provider Business Mailing Address
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Address Line | 1507 PHILADELPHIA PIKE APT A
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City | WILMINGTON
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State | DE
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Zip | 19809-1865
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Country | US
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Telephone | 302-798-9565
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Fax | 302-798-0792
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KEVIN ELLIOT DUHADAWAY
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Credential | P.T.
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Telephone | 302-798-9565
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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 | J10000187
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License Number State | DE
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