MEDICARE: JULIAN GONZALEZ PT, 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	PT032235	PA

General Provider Information

NPI Number	:	1942058565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIAN GONZALEZ PT, DPT

Provider Business Mailing Address
First Line	:	1734 DEKALB PIKE UNIT 4
Second Line	:
City	:	BLUE BELL
State	:	PA
Zip	:	19422-3352
Country	:	US
Telephone Number	:	610-707-8088
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 SCHUYLKILL RD STE 400
Second Line	:
City	:	PHOENIXVILLE
State	:	PA
Zip	:	19460-5218
Country	:	US
Telephone Number	:	610-917-0725
Fax Number	:

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

Provider Enumeration Date	:	05/08/2024
Last Update Date	:	05/14/2026

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