Organization Name: | OPTIMUM PHYSICAL THERAPY ASSOCIATES, P.C. |
NPI Number: | 1467521427 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CRAIG S FAVA (VICE PRESIDENT) |
Mailing Address: | 719 S Chester Rd Swarthmore |
State: | PA US |
Postal Code: | 190812710 |
Phone Number: | 6105434605 |
Fax Number: | |
NPI Enumeration Date: | 11/06/2006 |
NPI Last Update Date: | 06/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251G0304X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Geriatrics |
Taxonomy Definition: |