Basic Information
| Provider Information | |||||||||
| NPI: | 1881043941 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WHITE | ||||||||
| FirstName: | ROBERT | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1265 WAYNE AVE STE 308 | ||||||||
| Address2: | 119 PROFESSIONAL BUILDING | ||||||||
| City: | INDIANA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 157013501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7248018095 | ||||||||
| FaxNumber: | 7248018147 | ||||||||
| Practice Location | |||||||||
| Address1: | 1300 N CHARLOTTE ST | ||||||||
| Address2: | SUITE 14A | ||||||||
| City: | POTTSTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194642351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4847524372 | ||||||||
| FaxNumber: | 4847524376 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2016 | ||||||||
| LastUpdateDate: | 08/02/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT025277 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.