Provider Demographics
NPI:1386824860
Name:BETHESDA PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:BETHESDA PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WERTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:570-739-0905
Mailing Address - Street 1:219 N ROUTE 183
Mailing Address - Street 2:
Mailing Address - City:SCHUYLKILL HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17972-8828
Mailing Address - Country:US
Mailing Address - Phone:570-739-0905
Mailing Address - Fax:570-739-0907
Practice Address - Street 1:219 N ROUTE 183
Practice Address - Street 2:
Practice Address - City:SCHUYLKILL HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17972-8828
Practice Address - Country:US
Practice Address - Phone:570-739-0905
Practice Address - Fax:570-739-0907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy