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General NPI Number Information
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NPI Number | 1841916681
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Entity Type | Organization
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Legal Business Name | ADVANCED MOVEMENT AND BALANCE
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Dates
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Enumeration Date | 10/13/2022
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 3504 CRESSON ST
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City | PHILADELPHIA
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State | PA
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Zip | 19129-1648
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Country | US
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Telephone | 215-260-9258
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Fax |
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Provider Business Mailing Address
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Address Line | 3504 CRESSON ST
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City | PHILADELPHIA
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State | PA
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Zip | 19129-1648
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Country | US
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Telephone | 215-260-9258
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIE DIPAOLO
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Credential | PT, DPT, OCS
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Telephone | 215-260-9258
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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 |
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License Number State |
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