Provider Demographics
NPI:1346256153
Name:MULLIGAN PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:MULLIGAN PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MULLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:215-968-0156
Mailing Address - Street 1:660 NEWTOWN YARDLEY RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1759
Mailing Address - Country:US
Mailing Address - Phone:215-968-0156
Mailing Address - Fax:215-968-0157
Practice Address - Street 1:660 NEWTOWN YARDLEY RD
Practice Address - Street 2:SUITE 202
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1759
Practice Address - Country:US
Practice Address - Phone:215-968-0156
Practice Address - Fax:215-968-0157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA099865Medicare ID - Type UnspecifiedPHYSICAL THERAPY