Provider Demographics
NPI:1619911914
Name:MONTGOMERY COUNTY REHABILITATION & SPORTS THERAPY, P.C.
Entity Type:Organization
Organization Name:MONTGOMERY COUNTY REHABILITATION & SPORTS THERAPY, P.C.
Other - Org Name:DOLSON PHYSICAL THERAPY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:C.F.O. / ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GIULIANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-885-2022
Mailing Address - Street 1:170 W GERMANTOWN PIKE STE C3
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-1389
Mailing Address - Country:US
Mailing Address - Phone:610-279-6290
Mailing Address - Fax:610-279-7029
Practice Address - Street 1:170 W GERMANTOWN PIKE STE C3
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-1389
Practice Address - Country:US
Practice Address - Phone:610-279-6290
Practice Address - Fax:610-279-7029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000567078OtherHIGHMARK BLUE SHIELD
PA0437564000OtherINDEPENDENCE BLUE CROSS
PA1033495OtherKEYSTONE MERCY
PA54079OtherAETNA HEALTH PLAN
PA43-1622239M0209Medicaid