Provider Demographics
NPI:1902193063
Name:PT WORKS,LLC
Entity Type:Organization
Organization Name:PT WORKS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:PT,DPT
Authorized Official - Phone:215-925-1843
Mailing Address - Street 1:1010 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-1508
Mailing Address - Country:US
Mailing Address - Phone:215-925-1843
Mailing Address - Fax:215-925-1843
Practice Address - Street 1:950 N 3RD ST
Practice Address - Street 2:UNIT 1
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-2262
Practice Address - Country:US
Practice Address - Phone:215-925-1843
Practice Address - Fax:215-925-1843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019673174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty