Provider Demographics
NPI:1083924823
Name:MCLAUGHLIN PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:MCLAUGHLIN PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:SHAW
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-538-9245
Mailing Address - Street 1:308 JUNIPER ST
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1604
Mailing Address - Country:US
Mailing Address - Phone:215-538-9245
Mailing Address - Fax:215-538-9984
Practice Address - Street 1:308 JUNIPER ST
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1604
Practice Address - Country:US
Practice Address - Phone:215-538-9245
Practice Address - Fax:215-538-9984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008495L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1902908726OtherINDIVIDUAL NPI
PA038874OtherMEDICARE PTAN