Provider Demographics
NPI: | 1093062697 |
---|---|
Name: | OLD TOWNE PHYSICAL THERAPY LIMITED PARTNERSHIP |
Entity type: | Organization |
Organization Name: | OLD TOWNE PHYSICAL THERAPY LIMITED PARTNERSHIP |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | VP, AUTHORIZED OFFICIAL |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RICHARD |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BINSTEIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 713-297-7000 |
Mailing Address - Street 1: | 32695 LONG NECK RD |
Mailing Address - Street 2: | BLDG 1 UNIT 3 |
Mailing Address - City: | MILLSBORO |
Mailing Address - State: | DE |
Mailing Address - Zip Code: | 19966-6693 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 302-839-0900 |
Mailing Address - Fax: | 302-839-0901 |
Practice Address - Street 1: | 32695 LONG NECK RD |
Practice Address - Street 2: | BLDG 1 UNIT 3 |
Practice Address - City: | MILLSBORO |
Practice Address - State: | DE |
Practice Address - Zip Code: | 19966-6693 |
Practice Address - Country: | US |
Practice Address - Phone: | 302-839-0900 |
Practice Address - Fax: | 302-839-0901 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-08-14 |
Last Update Date: | 2012-08-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |