MEDICARE: PHYSICAL THERAPY PHYSICIANS PC

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	208100000X	Physical Medicine & Rehabilitation Physician	MD039149L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619142353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICAL THERAPY PHYSICIANS PC

Provider Business Mailing Address
First Line	:	PO BOX 374
Second Line	:
City	:	FOLSOM
State	:	PA
Zip	:	19033-0374
Country	:	US
Telephone Number	:	610-532-2633
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 E BEACON LIGHT LN
Second Line	:
City	:	CHESTER
State	:	PA
Zip	:	19013-4433
Country	:	US
Telephone Number	:	610-532-2633
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES FRANCIS BONNER
Credential	:	MD
Telephone Number	:	610-532-2633

Provider Enumeration Date	:	04/24/2008
Last Update Date	:	04/24/2008

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