Provider Demographics
NPI:1952922601
Name:YOURPT LLC
Entity Type:Organization
Organization Name:YOURPT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:DIKSA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:302-690-9243
Mailing Address - Street 1:5 CASTLE ROCK DR
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-1206
Mailing Address - Country:US
Mailing Address - Phone:302-690-9243
Mailing Address - Fax:
Practice Address - Street 1:5 CASTLE ROCK DR
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-1206
Practice Address - Country:US
Practice Address - Phone:302-690-9243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-05
Last Update Date:2020-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty