Provider Demographics
NPI:1942932645
Name:LIGHT THE LAMP PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:LIGHT THE LAMP PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAULIEU BIELE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:484-681-2774
Mailing Address - Street 1:730 ROY RD
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1957
Mailing Address - Country:US
Mailing Address - Phone:484-431-5724
Mailing Address - Fax:
Practice Address - Street 1:610 S HENDERSON RD FL 2
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3517
Practice Address - Country:US
Practice Address - Phone:484-681-2774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-30
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1245419803OtherNPI CHRISTINA BIELE PT, DPT
PA1912500620OtherNPI ZACHARY JULIANO PT, DPT