Provider Demographics
NPI:1629428214
Name:WINTERS, RICHARD DOUGLAS JR (DPT)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:DOUGLAS
Last Name:WINTERS
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 JOHNSVILLE BLVD STE 1100
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-3536
Mailing Address - Country:US
Mailing Address - Phone:215-441-9194
Mailing Address - Fax:215-441-9196
Practice Address - Street 1:720 JOHNSVILLE BLVD STE 1100
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-3536
Practice Address - Country:US
Practice Address - Phone:215-441-9194
Practice Address - Fax:215-441-9196
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025280225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist