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General NPI Number Information
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NPI Number | 1891823522
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Entity Type | Organization
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Legal Business Name | FOULDS PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 12/08/2008
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Provider Practice Location Address
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Address Line | 4145 STATE ROUTE 147
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City | HERNDON
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State | PA
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Zip | 17830-7311
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Country | US
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Telephone | 570-758-2080
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Fax | 570-758-2081
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Provider Business Mailing Address
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Address Line | 4145 STATE ROUTE 147
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City | HERNDON
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State | PA
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Zip | 17830-7311
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Country | US
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Telephone | 570-758-2080
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Fax | 570-758-2081
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Authorized Official
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Title or Position | CEO PHYSICAL THERAPIST
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Name | DANA L FOULDS
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Credential | MPT
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Telephone | 570-758-2080
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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 | PT008487L
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License Number State | PA
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