MEDICARE: MR. WALTER GEORGE SCARBOROUGH JR. PT

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	PT013152L	PA

General Provider Information

NPI Number	:	1922075175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WALTER GEORGE SCARBOROUGH JR. PT

Provider Business Mailing Address
First Line	:	3137 ADDISON CT
Second Line	:
City	:	BENSALEM
State	:	PA
Zip	:	19020-1810
Country	:	US
Telephone Number	:	215-891-1898
Fax Number	:

Provider Business Practice Location Address
First Line	:	360 OXFORD VALLEY RD
Second Line	:
City	:	LANGHORNE
State	:	PA
Zip	:	19047-8302
Country	:	US
Telephone Number	:	215-943-9000
Fax Number	:

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

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	07/08/2007

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