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General NPI Number Information
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NPI Number | 1720503055
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Entity Type | Organization
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Legal Business Name | EPIC DEVELOPMENTAL SERVICES
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Dates
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Enumeration Date | 08/08/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2300 NAUDAIN ST APT N
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City | PHILADELPHIA
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State | PA
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Zip | 19146-1171
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Country | US
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Telephone | 732-581-6524
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 NAUDAIN ST. UNIT N
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City | PHILADELPHIA
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State | PA
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Zip | 19146
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Country | US
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Telephone | 732-581-6524
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | LAURA CURRAN
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Credential | PT
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Telephone | 732-581-6524
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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 | PT026376
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License Number State | PA
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