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NPI Code Detail

MEDICARE: MS. JEANNINE MARIE FOX PTA

MEDICARE: MS. JEANNINE MARIE FOX PTA
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
1225200000XPhysical Therapy AssistantTEI003263PA

General Provider Information

NPI Number : 1760786677
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JEANNINE MARIE FOX PTA
Provider Business Mailing Address
First Line : 2161 JOSHUA RD
Second Line :
City : LAFAYETTE HILL
State : PA
Zip : 19444-2400
Country : US
Telephone Number : 610-397-0906
Fax Number :
Provider Business Practice Location Address
First Line : 850 PAPER MILL RD
Second Line :
City : GLENSIDE
State : PA
Zip : 19038-7833
Country : US
Telephone Number : 215-402-8833
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2011
Last Update Date : 07/06/2017

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Directions to “ MS. JEANNINE MARIE FOX PTA” Practice Location

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