Provider Demographics
NPI:1609841386
Name:READING BERKS PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:READING BERKS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:HETZEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT DPT ATC
Authorized Official - Phone:610-921-0609
Mailing Address - Street 1:40 BERKSHIRE COURT
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610
Mailing Address - Country:US
Mailing Address - Phone:610-372-0902
Mailing Address - Fax:610-372-0966
Practice Address - Street 1:40 BERKSHIRE COURT
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610
Practice Address - Country:US
Practice Address - Phone:610-372-0902
Practice Address - Fax:610-372-0966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2012-10-31
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
026993Medicare ID - Type Unspecified