Provider Demographics
NPI:1457828204
Name:FREESTYLE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:FREESTYLE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:302-897-6360
Mailing Address - Street 1:144 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-1738
Mailing Address - Country:US
Mailing Address - Phone:302-896-6360
Mailing Address - Fax:
Practice Address - Street 1:713 ACE MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-1037
Practice Address - Country:US
Practice Address - Phone:302-897-6360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-30
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy