MEDICARE: JAMES K. BARD P.T.

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	PT005266L	PA

General Provider Information

NPI Number	:	1679879274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES K. BARD P.T.

Provider Business Mailing Address
First Line	:	409 SECOND AVE
Second Line	:	SUITE 202
City	:	COLLEGEVILLE
State	:	PA
Zip	:	19426-3625
Country	:	US
Telephone Number	:	610-489-5772
Fax Number	:	610-454-7726

Provider Business Practice Location Address
First Line	:	409 SECOND AVE
Second Line	:	SUITE 202
City	:	COLLEGEVILLE
State	:	PA
Zip	:	19426-3625
Country	:	US
Telephone Number	:	610-489-5772
Fax Number	:	610-454-7726

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

Provider Enumeration Date	:	01/31/2011
Last Update Date	:	05/04/2015

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