Provider Demographics
NPI:1134196744
Name:MAILE, MARGERY ELLEN (PT)
Entity type:Individual
Prefix:MRS
First Name:MARGERY
Middle Name:ELLEN
Last Name:MAILE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 CHESTNUT ST 1402
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4404
Mailing Address - Country:US
Mailing Address - Phone:800-321-9999
Mailing Address - Fax:267-339-3761
Practice Address - Street 1:2400 MARYLAND RD
Practice Address - Street 2:SUITE 10
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1700
Practice Address - Country:US
Practice Address - Phone:215-657-1115
Practice Address - Fax:215-657-1848
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT005759-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist