| Organization Name: | MAIN LINE PHYSICAL THERAPY LLC |
| NPI Number: | 1588873558 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THEODORE R ELLIS (MEMBER) |
| Mailing Address: | 150 Strafford Ave Suite 230 Wayne |
| State: | PA US |
| Postal Code: | 190873114 |
| Phone Number: | 6109716969 |
| Fax Number: | 6109719444 |
| NPI Enumeration Date: | 05/22/2007 |
| NPI Last Update Date: | 06/30/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PA008710-E |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |