Provider Demographics
NPI:1750767703
Name:BOEGLY, ERICA (PT, DPT, ATC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:BOEGLY
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 TURNER LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4533
Mailing Address - Country:US
Mailing Address - Phone:610-344-9725
Mailing Address - Fax:610-344-9728
Practice Address - Street 1:133 TURNER LN
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4533
Practice Address - Country:US
Practice Address - Phone:610-344-9725
Practice Address - Fax:610-344-9728
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT024569225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist