Provider Demographics
NPI:1780679738
Name:MANUAL ORTHOPAEDIC PHYSIOTHERAPY CHARTERED
Entity type:Organization
Organization Name:MANUAL ORTHOPAEDIC PHYSIOTHERAPY CHARTERED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:T
Authorized Official - Last Name:VAN DOORNE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:302-888-2551
Mailing Address - Street 1:2323 PENNSYLVANIA AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-1332
Mailing Address - Country:US
Mailing Address - Phone:302-888-2551
Mailing Address - Fax:302-888-2571
Practice Address - Street 1:2323 PENNSYLVANIA AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-1332
Practice Address - Country:US
Practice Address - Phone:302-888-2551
Practice Address - Fax:302-888-2571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2001105175261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy