MEDICARE: VITAL LINK PHYSICAL THERAPY, 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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1689743098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL LINK PHYSICAL THERAPY, PC

Provider Business Mailing Address
First Line	:	PO BOX 411
Second Line	:
City	:	FURLONG
State	:	PA
Zip	:	18925-0411
Country	:	US
Telephone Number	:	215-794-9144
Fax Number	:	215-794-1944

Provider Business Practice Location Address
First Line	:	3488 YORK RD
Second Line	:
City	:	FURLONG
State	:	PA
Zip	:	18925-1227
Country	:	US
Telephone Number	:	215-794-1944
Fax Number	:	215-794-1944

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	DR. BENJAMIN P WHITE
Credential	:	DPT
Telephone Number	:	215-794-1944

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	08/22/2020

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