Provider Demographics
NPI:1497402945
Name:INVICTUS PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:INVICTUS PHYSICAL THERAPY LLC
Other - Org Name:INVICTUS PHYSICAL THERAPY AND WELLNESS
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:RATHZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS
Authorized Official - Phone:267-838-2163
Mailing Address - Street 1:100 N 20TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-1443
Mailing Address - Country:US
Mailing Address - Phone:267-548-4476
Mailing Address - Fax:
Practice Address - Street 1:100 N 20TH ST FL 1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-1443
Practice Address - Country:US
Practice Address - Phone:267-548-4476
Practice Address - Fax:267-548-4478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-04
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty