Basic Information
| Provider Information | |||||||||
| NPI: | 1184662116 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SPRINGFIELD REHABILITATION ASSOCIATES, LLC | ||||||||
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| OtherOrganizationName: | SMART REHABILITATION ASSOCIATES, LLC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 176 S. NEW MIDDLETOWN ROAD | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | MEDIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108927344 | ||||||||
| FaxNumber: | 6108927304 | ||||||||
| Practice Location | |||||||||
| Address1: | 176 S NEW MIDDLETOWN ROAD | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | MEDIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108927344 | ||||||||
| FaxNumber: | 6108927304 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2006 | ||||||||
| LastUpdateDate: | 05/12/2014 | ||||||||
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| AuthorizedOfficialLastName: | MURPHY | ||||||||
| AuthorizedOfficialFirstName: | COLETTE | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6108927344 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 05007485L | PA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.