Provider Demographics
NPI:1508985763
Name:INFORZATO, MICHAEL HUNTER (PTA)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:HUNTER
Last Name:INFORZATO
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 CROOKED LN
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3658
Mailing Address - Country:US
Mailing Address - Phone:610-630-9016
Mailing Address - Fax:
Practice Address - Street 1:1021 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-4406
Practice Address - Country:US
Practice Address - Phone:610-272-5213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE-002611225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant