Provider Demographics
NPI:1295492577
Name:WOODLYN PHYSICAL THERAPY
Entity type:Organization
Organization Name:WOODLYN PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRENNAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:302-366-7600
Mailing Address - Street 1:WOODLYN PHYSICAL THERAPY 1082 OLD CHURCHMANS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2143
Mailing Address - Country:US
Mailing Address - Phone:302-366-7600
Mailing Address - Fax:610-601-4416
Practice Address - Street 1:WOODLYN PHYSICAL THERAPY 1082 OLD CHURCHMANS RD STE 101
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2143
Practice Address - Country:US
Practice Address - Phone:302-366-7600
Practice Address - Fax:610-601-4416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1336320209OtherNPI USED FOR WOODLYN PHYSICAL THERAPY IN DELAWARE