Provider Demographics
NPI:1962937581
Name:FOOT & ANKLE PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:FOOT & ANKLE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAMALA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONGIORNO
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:610-270-0370
Mailing Address - Street 1:931 E HAVERFORD RD
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3838
Mailing Address - Country:US
Mailing Address - Phone:610-642-5040
Mailing Address - Fax:610-642-5042
Practice Address - Street 1:931 E HAVERFORD RD
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3838
Practice Address - Country:US
Practice Address - Phone:610-642-5040
Practice Address - Fax:610-642-5042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty