Provider Demographics
NPI:1427365220
Name:HAERLING, PAUL VERNON (PT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:VERNON
Last Name:HAERLING
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 W EAGLE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-2234
Mailing Address - Country:US
Mailing Address - Phone:610-789-9887
Mailing Address - Fax:
Practice Address - Street 1:57 W EAGLE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2234
Practice Address - Country:US
Practice Address - Phone:610-789-9887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020756225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist