Provider Demographics
NPI:1780450106
Name:OGUNSEMOWO, INIOLUWA HAVILAH (DPT)
Entity type:Individual
Prefix:
First Name:INIOLUWA
Middle Name:HAVILAH
Last Name:OGUNSEMOWO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 E HECTOR ST APT 208
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-0018
Mailing Address - Country:US
Mailing Address - Phone:240-753-4858
Mailing Address - Fax:
Practice Address - Street 1:555 BUSINESS CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-3434
Practice Address - Country:US
Practice Address - Phone:215-293-8882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics