Provider Demographics
NPI:1598802431
Name:AMBLER PHYSICAL THERAPY & SPORTS REHABILITATION LLC
Entity Type:Organization
Organization Name:AMBLER PHYSICAL THERAPY & SPORTS REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:215-646-6135
Mailing Address - Street 1:228 FULLING MILL LN
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-4201
Mailing Address - Country:US
Mailing Address - Phone:215-643-9250
Mailing Address - Fax:215-643-9251
Practice Address - Street 1:45 FOREST AVE
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-4523
Practice Address - Country:US
Practice Address - Phone:215-643-9250
Practice Address - Fax:215-643-9251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy