Provider Demographics
NPI:1669407284
Name:SENIOR PHYSICAL THERAPY SERVICES LLC
Entity type:Organization
Organization Name:SENIOR PHYSICAL THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SHERER
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:215-366-5978
Mailing Address - Street 1:695 MAIN ST
Mailing Address - Street 2:#400
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-1671
Mailing Address - Country:US
Mailing Address - Phone:267-933-6410
Mailing Address - Fax:866-826-0604
Practice Address - Street 1:695 MAIN ST
Practice Address - Street 2:#400
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-1671
Practice Address - Country:US
Practice Address - Phone:215-366-5978
Practice Address - Fax:215-366-5956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT010215L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA083393-S6DMedicare PIN