Basic Information
| Provider Information | |||||||||
| NPI: | 1275546699 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RICE | ||||||||
| FirstName: | TATE | ||||||||
| MiddleName: | LAULENEKE | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1777 SENTRY PKWY W | ||||||||
| Address2: | DUBLIN HALL, SUITE 101 | ||||||||
| City: | BLUE BELL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194222207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102771100 | ||||||||
| FaxNumber: | 2156461900 | ||||||||
| Practice Location | |||||||||
| Address1: | 1777 SENTRY PKWY W | ||||||||
| Address2: | DUBLIN HALL, SUITE 101 | ||||||||
| City: | BLUE BELL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194222207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102771100 | ||||||||
| FaxNumber: | 2156461900 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2006 | ||||||||
| LastUpdateDate: | 03/27/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | QAU9096 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.