Provider Demographics
NPI:1003232554
Name:MISHOCK PHYSICAL THERAPY LP
Entity Type:Organization
Organization Name:MISHOCK PHYSICAL THERAPY LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-297-7000
Mailing Address - Street 1:214 S NEWTOWN STREET RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-4000
Mailing Address - Country:US
Mailing Address - Phone:610-624-5111
Mailing Address - Fax:610-624-1324
Practice Address - Street 1:214 S NEWTOWN STREET RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-4000
Practice Address - Country:US
Practice Address - Phone:610-624-5111
Practice Address - Fax:610-624-1324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-07
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty