Provider Demographics
NPI:1588115596
Name:EGE, HONEY FRITZIE
Entity type:Individual
Prefix:
First Name:HONEY
Middle Name:FRITZIE
Last Name:EGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HONEY
Other - Middle Name:FRITZIE
Other - Last Name:LUISTRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1591 BURGOYNE RD
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-3917
Mailing Address - Country:US
Mailing Address - Phone:484-340-6982
Mailing Address - Fax:
Practice Address - Street 1:1615 E BOOT RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-6001
Practice Address - Country:US
Practice Address - Phone:484-227-8809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012585L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist