Provider Demographics
NPI:1184665507
Name:WEST CHESTER PHYSICAL THERAPY & FITNESS CENTER, PC
Entity Type:Organization
Organization Name:WEST CHESTER PHYSICAL THERAPY & FITNESS CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIOLET
Authorized Official - Middle Name:L
Authorized Official - Last Name:BATEJAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:610-436-9878
Mailing Address - Street 1:1450 E BOOT RD
Mailing Address - Street 2:SUITE 200C
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-5300
Mailing Address - Country:US
Mailing Address - Phone:610-436-9878
Mailing Address - Fax:610-436-7565
Practice Address - Street 1:1450 E BOOT RD
Practice Address - Street 2:SUITE 200C
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-5300
Practice Address - Country:US
Practice Address - Phone:610-436-9878
Practice Address - Fax:610-436-7565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002680L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACJ5730OtherRAILROAD MEDICARE
PA0747742000OtherIBC
PA568418OtherHBS
PACJ5730OtherRAILROAD MEDICARE