Provider Demographics
NPI:1154790210
Name:FUNCTIONAL TESTING & CONSULTING, INC47
Entity type:Organization
Organization Name:FUNCTIONAL TESTING & CONSULTING, INC47
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:267-355-3376
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-0102
Mailing Address - Country:US
Mailing Address - Phone:267-355-3376
Mailing Address - Fax:
Practice Address - Street 1:52 BRAE BOURNE DR
Practice Address - Street 2:
Practice Address - City:RICHBORO
Practice Address - State:PA
Practice Address - Zip Code:18954-1417
Practice Address - Country:US
Practice Address - Phone:267-355-3376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT005507L261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy