Provider Demographics
NPI:1063948073
Name:PROACTION PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:PROACTION PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:215-266-8036
Mailing Address - Street 1:902 N BROAD ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-2323
Mailing Address - Country:US
Mailing Address - Phone:215-266-8036
Mailing Address - Fax:
Practice Address - Street 1:902 N BROAD ST
Practice Address - Street 2:SUITE 103
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-2323
Practice Address - Country:US
Practice Address - Phone:215-266-8036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021738261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy