Provider Demographics
NPI:1104874544
Name:TOOHER, JOHN P (PT, AT, C)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:TOOHER
Suffix:
Gender:M
Credentials:PT, AT, C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 CONSHOHOCKEN STATE RD
Mailing Address - Street 2:1B
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-3327
Mailing Address - Country:US
Mailing Address - Phone:215-913-0484
Mailing Address - Fax:610-668-0668
Practice Address - Street 1:100 PRESIDENTIAL BLVD
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1108
Practice Address - Country:US
Practice Address - Phone:610-668-0904
Practice Address - Fax:610-668-0668
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008548L225100000X
PART002030A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer