Provider Demographics
NPI:1982948477
Name:NUSS, JOHN K (PTA)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:K
Last Name:NUSS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 CHATHAM LN
Mailing Address - Street 2:
Mailing Address - City:SCHWENKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19473-2822
Mailing Address - Country:US
Mailing Address - Phone:610-287-9740
Mailing Address - Fax:
Practice Address - Street 1:804 CHATHAM LN
Practice Address - Street 2:
Practice Address - City:SCHWENKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19473-2822
Practice Address - Country:US
Practice Address - Phone:610-287-9740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE1000908225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant