Provider Demographics
NPI:1083401699
Name:MCMAHON, RUTH (PTA)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:MCMAHON
Suffix:
Gender:
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MACDADE BLVD APT A207
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:PA
Mailing Address - Zip Code:19033-2936
Mailing Address - Country:US
Mailing Address - Phone:215-510-3767
Mailing Address - Fax:
Practice Address - Street 1:555 E LANCASTER AVE STE N100
Practice Address - Street 2:
Practice Address - City:RADNOR
Practice Address - State:PA
Practice Address - Zip Code:19087-5158
Practice Address - Country:US
Practice Address - Phone:484-577-8950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI006884225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant