MEDICARE: DR. JEANNE DARCY ERTHAL PT, MSPT, 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	PT012189L	PA

General Provider Information

NPI Number	:	1952526253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEANNE DARCY ERTHAL PT, MSPT, DPT

Provider Business Mailing Address
First Line	:	5 BRADFORD CIR
Second Line	:
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-2836
Country	:	US
Telephone Number	:	610-220-0942
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 BRADFORD CIR
Second Line	:
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-2836
Country	:	US
Telephone Number	:	610-220-0942
Fax Number	:

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

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	07/08/2007

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