MEDICARE: DR. DANIEL THAIN SCHROCK DPT

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	PT016334	PA

General Provider Information

NPI Number	:	1912123043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL THAIN SCHROCK DPT

Provider Business Mailing Address
First Line	:	3375 WHITEHALL DR.
Second Line	:
City	:	WILLOW GROVE
State	:	PA
Zip	:	19009
Country	:	US
Telephone Number	:	215-659-6633
Fax Number	:

Provider Business Practice Location Address
First Line	:	3375 WHITEHALL DR
Second Line	:
City	:	WILLOW GROVE
State	:	PA
Zip	:	19090-1913
Country	:	US
Telephone Number	:	215-659-6633
Fax Number	:

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

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	07/08/2007

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