Basic Information
| Provider Information | |||||||||
| NPI: | 1336863943 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JAMES | ||||||||
| FirstName: | DYLAN | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11 SHADY HOLLOW LN | ||||||||
| Address2: | |||||||||
| City: | SHILLINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 196073004 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4301 PENN AVE | ||||||||
| Address2: | |||||||||
| City: | SINKING SPRING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 196081370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109274136 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2022 | ||||||||
| LastUpdateDate: | 09/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT030627 | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.