Provider Demographics
NPI:1588634752
Name:FOUNDERS PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:FOUNDERS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:V
Authorized Official - Last Name:VERNACE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-527-9500
Mailing Address - Street 1:101 S BRYN MAWR AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3120
Mailing Address - Country:US
Mailing Address - Phone:610-527-3300
Mailing Address - Fax:610-525-5508
Practice Address - Street 1:101 S BRYN MAWR AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3120
Practice Address - Country:US
Practice Address - Phone:610-527-3300
Practice Address - Fax:610-525-5508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1756928OtherHIGHMARK BLUE SHIELD
PADD7737OtherTRAVELERS MEDICARE
PADD7737OtherTRAVELERS MEDICARE