MEDICARE: JAMES SCHICKLING JR. PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT-006717-L	PA

General Provider Information

NPI Number	:	1083662563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES SCHICKLING JR. PT

Provider Business Mailing Address
First Line	:	549 SHERMAN RD
Second Line	:
City	:	SPRINGFIELD
State	:	PA
Zip	:	19064-3436
Country	:	US
Telephone Number	:	610-328-2312
Fax Number	:

Provider Business Practice Location Address
First Line	:	2906 ISLAND AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19153-2026
Country	:	US
Telephone Number	:	215-365-2113
Fax Number	:	215-365-5516

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	07/08/2007

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