Basic Information
| Provider Information | |||||||||
| NPI: | 1467793158 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BUCKS PHYSICAL & SPORTS REHABILITATION LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 ALMSHOUSE RD | ||||||||
| Address2: | |||||||||
| City: | RICHBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189541108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153572000 | ||||||||
| FaxNumber: | 2153578499 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 ALMSHOUSE RD | ||||||||
| Address2: | |||||||||
| City: | RICHBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189541108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153572000 | ||||||||
| FaxNumber: | 2153578499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2013 | ||||||||
| LastUpdateDate: | 03/06/2013 | ||||||||
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| AuthorizedOfficialLastName: | GREGORY | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | F | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2153572000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | DN004512 | PA | Y | 193200000X MULTI-SPECIALTY GROUP | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.