Provider Demographics
NPI:1467930503
Name:RIDGEWOOD PHYSICAL THERAPY SERVICES
Entity Type:Organization
Organization Name:RIDGEWOOD PHYSICAL THERAPY SERVICES
Other - Org Name:WYOMISSING PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-781-5918
Mailing Address - Street 1:2625 CUMBERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-2111
Mailing Address - Country:US
Mailing Address - Phone:610-781-5918
Mailing Address - Fax:
Practice Address - Street 1:2201 RIDGEWOOD RD STE 210
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1196
Practice Address - Country:US
Practice Address - Phone:610-781-5918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty