Provider Demographics
NPI:1003190620
Name:MOUNT, MICHAEL N (PT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:N
Last Name:MOUNT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 MARSHALL STREET
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348
Mailing Address - Country:US
Mailing Address - Phone:484-467-2417
Mailing Address - Fax:
Practice Address - Street 1:1214 BEAVER BROOK PLZ STE A
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-8632
Practice Address - Country:US
Practice Address - Phone:302-544-4388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-021629225100000X
DEJ1-0003356225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist