Provider Demographics
NPI:1306050679
Name:BUDICH, JUSTIN (PT DPT)
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:
Last Name:BUDICH
Suffix:
Gender:M
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 NESHAMINY VALLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020
Mailing Address - Country:US
Mailing Address - Phone:443-812-4764
Mailing Address - Fax:
Practice Address - Street 1:3333 STREET RD
Practice Address - Street 2:ONE GREENWOOD SQ STE 320 COMPREHENSIVE SPORTS CARE SPEC
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020
Practice Address - Country:US
Practice Address - Phone:215-638-3597
Practice Address - Fax:215-638-7430
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0186452251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic