Basic Information
| Provider Information | |||||||||
| NPI: | 1497244750 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DHIMMER | ||||||||
| FirstName: | KHUSHBU | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 W GERMANTOWN PIKE STE 100 | ||||||||
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| City: | PLYMOUTH MEETING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194621420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102700370 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1608 WALNUT ST | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191035457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155458717 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2018 | ||||||||
| LastUpdateDate: | 05/02/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.