Provider Demographics
NPI:1750010492
Name:PT WORKS DE, LLC
Entity Type:Organization
Organization Name:PT WORKS DE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:MUNOZ
Authorized Official - Last Name:RODRIGUERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-422-2518
Mailing Address - Street 1:907 N DUPONT BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-1060
Mailing Address - Country:US
Mailing Address - Phone:302-422-2518
Mailing Address - Fax:
Practice Address - Street 1:907 N DUPONT BLVD STE 104
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1060
Practice Address - Country:US
Practice Address - Phone:302-422-2518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy