Provider Demographics
NPI:1376182170
Name:VALLEY PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:VALLEY PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:267-406-8309
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-0069
Mailing Address - Country:US
Mailing Address - Phone:215-360-7824
Mailing Address - Fax:215-501-5108
Practice Address - Street 1:1810 COUNTY LINE RD STE 400
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1720
Practice Address - Country:US
Practice Address - Phone:215-360-7824
Practice Address - Fax:215-501-5108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-27
Last Update Date:2022-07-05
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
PA1027050340003Medicaid