MEDICARE: DR. ANNE KEELER GALGON PT, PHD, NCS,

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	PT006388L	PA

General Provider Information

NPI Number	:	1528350766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE KEELER GALGON PT, PHD, NCS,

Provider Business Mailing Address
First Line	:	128 LISMORE AVE
Second Line	:
City	:	GLENSIDE
State	:	PA
Zip	:	19038-4011
Country	:	US
Telephone Number	:	215-885-8472
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 EASTON RD
Second Line	:	101 MANOR
City	:	WILLOW GROVE
State	:	PA
Zip	:	19090-2028
Country	:	US
Telephone Number	:	215-659-7759
Fax Number	:

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

Provider Enumeration Date	:	05/06/2011
Last Update Date	:	05/06/2011

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