MEDICARE: MR. JEFFREY W SKOLNY MSPT

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	PT018343	PA

General Provider Information

NPI Number	:	1346340056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY W SKOLNY MSPT

Provider Business Mailing Address
First Line	:	1806 SWAMP PIKE STE 100
Second Line	:
City	:	GILBERTSVILLE
State	:	PA
Zip	:	19525-9307
Country	:	US
Telephone Number	:	610-327-2600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1311 ROUTE 100 LOWR LEVEL
Second Line	:
City	:	BARTO
State	:	PA
Zip	:	19504-8724
Country	:	US
Telephone Number	:	610-845-5000
Fax Number	:

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

Provider Enumeration Date	:	09/23/2006
Last Update Date	:	09/04/2013

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