Provider Demographics
NPI:1275546699
Name:RICE, TATE LAULENEKE (DPT)
Entity Type:Individual
Prefix:
First Name:TATE
Middle Name:LAULENEKE
Last Name:RICE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 SENTRY PKWY W
Mailing Address - Street 2:DUBLIN HALL, SUITE 101
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-2207
Mailing Address - Country:US
Mailing Address - Phone:610-277-1100
Mailing Address - Fax:215-646-1900
Practice Address - Street 1:1777 SENTRY PKWY W
Practice Address - Street 2:DUBLIN HALL, SUITE 101
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2207
Practice Address - Country:US
Practice Address - Phone:610-277-1100
Practice Address - Fax:215-646-1900
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQAU9096225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396667AMedicare ID - Type UnspecifiedMEDICARE
NJ316643Medicare ID - Type UnspecifiedMEDICARE #