Provider Demographics
NPI:1467603720
Name:PT HEALTHCARE PROVIDERS LLC
Entity Type:Organization
Organization Name:PT HEALTHCARE PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:COBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-862-8135
Mailing Address - Street 1:718 FOX TAIL CT
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:PA
Mailing Address - Zip Code:18938-5775
Mailing Address - Country:US
Mailing Address - Phone:215-862-8135
Mailing Address - Fax:
Practice Address - Street 1:718 FOX TAIL CT
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:PA
Practice Address - Zip Code:18938-5775
Practice Address - Country:US
Practice Address - Phone:215-862-8135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy