Provider Demographics
NPI:1518405489
Name:TIZZARD, JOSHUA
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:TIZZARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 HORSHAM RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-2140
Mailing Address - Country:US
Mailing Address - Phone:215-442-9060
Mailing Address - Fax:
Practice Address - Street 1:400 HORSHAM RD
Practice Address - Street 2:SUITE 105
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2140
Practice Address - Country:US
Practice Address - Phone:215-442-9060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0258462251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic