Basic Information
| Provider Information | |||||||||
| NPI: | 1801256722 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HESS | ||||||||
| FirstName: | MICHELE | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | MSPT | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | NOLAN | ||||||||
| OtherFirstName: | MICHELE | ||||||||
| OtherMiddleName: | P | ||||||||
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| OtherCredential: | MSPT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 833 CHESTNUT ST | ||||||||
| Address2: | SUITE 1402 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191074414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2673393603 | ||||||||
| FaxNumber: | 2673393761 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 ENTERPRISE DR | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | LIMERICK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194681218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4849325060 | ||||||||
| FaxNumber: | 6104951587 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2016 | ||||||||
| LastUpdateDate: | 03/04/2016 | ||||||||
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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 | 225100000X | PT006851L | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.