Provider Demographics
NPI:1073072401
Name:MUETTERTIES, AUSTIN THOMAS
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:THOMAS
Last Name:MUETTERTIES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 W CHESTER PIKE STE 150
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-0259
Mailing Address - Country:US
Mailing Address - Phone:610-359-5671
Mailing Address - Fax:610-359-1519
Practice Address - Street 1:501 MACDADE BLVD FL 2
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:PA
Practice Address - Zip Code:19033
Practice Address - Country:US
Practice Address - Phone:610-586-7000
Practice Address - Fax:610-586-7004
Is Sole Proprietor?:No
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT027552225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist