Basic Information
| Provider Information | |||||||||
| NPI: | 1427524016 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JMB THERAPY SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 890 LANCASTER AVE | ||||||||
| Address2: | |||||||||
| City: | DEVON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193332360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102252451 | ||||||||
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| Practice Location | |||||||||
| Address1: | 890 LANCASTER AVE | ||||||||
| Address2: | |||||||||
| City: | DEVON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193332360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102252451 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2018 | ||||||||
| LastUpdateDate: | 10/22/2018 | ||||||||
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| AuthorizedOfficialLastName: | BROWN | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PT/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6102252451 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT, DPT, GCS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251G0304X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Geriatrics | 225X00000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.