Provider Demographics
NPI:1477831030
Name:PLUMB LINE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:PLUMB LINE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:GRUBB
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:610-953-3232
Mailing Address - Street 1:955 BEN FRANKLIN HWY W
Mailing Address - Street 2:SUITE 7
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19518-1048
Mailing Address - Country:US
Mailing Address - Phone:610-953-3232
Mailing Address - Fax:610-953-3230
Practice Address - Street 1:955 BEN FRANKLIN HWY W
Practice Address - Street 2:SUITE 7
Practice Address - City:DOUGLASSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19518-1048
Practice Address - Country:US
Practice Address - Phone:610-953-3232
Practice Address - Fax:610-953-3230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018213261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3871816000OtherINDEPENDENCE
PA0403205OtherCIGNA
PA2674765OtherHIGHMARK BS