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NPI Code Detail

MEDICARE: JEFFREY KEITH O'NEILL DPT

MEDICARE: JEFFREY KEITH O'NEILL DPT
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
1225100000XPhysical TherapistPT017420PA

General Provider Information

NPI Number : 1134196660
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY KEITH O'NEILL DPT
Provider Business Mailing Address
First Line : 420 BAINBRIDGE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19147-1568
Country : US
Telephone Number : 215-629-3837
Fax Number : 215-629-5531
Provider Business Practice Location Address
First Line : 420 BAINBRIDGE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19147-1568
Country : US
Telephone Number : 215-629-1270
Fax Number : 215-629-1293
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2006
Last Update Date : 04/22/2008

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Directions to “ JEFFREY KEITH O'NEILL DPT” Practice Location

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