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General NPI Number Information
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NPI Number | 1649234923
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Entity Type | Organization
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Legal Business Name | PAIN RELIEF AND PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 57 W EAGLE RD SUITE 1
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City | HAVERTOWN
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State | PA
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Zip | 19083-2234
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Country | US
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Telephone | 610-789-9887
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Fax | 610-789-9883
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Provider Business Mailing Address
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Address Line | 57 W EAGLE RD
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City | HAVERTOWN
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State | PA
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Zip | 19083-2234
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Country | US
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Telephone | 610-789-1599
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Fax | 610-789-9883
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ADDISON JADE LERNER-LENTZ
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Credential | DPT, FAAOMPT, COMT
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Telephone | 610-789-9887
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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 | PT-002907-E
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License Number State | PA
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