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Organization
PHOENIX PHYSICAL THERAPY REHAB CTR
Active
Organization
PHOENIX PHYSICAL THERAPY REHAB CTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN ASHLEY PREWITT (SOLE OWNER)
(215) 991-9911
Entity
Organization
Contact information
Practice address
4943 GERMANTOWN AVE, PHILADELPHIA, PA 19144-5962
(215) 991-9911
(215) 991-9913
Mailing address
PO BOX 26461, PHILADELPHIA, PA 19141-6461
(215) 991-9911
(215) 991-9913
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-006992-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014008940001
—
PA
01
—
0140089403
AMERICHOICE
PA
01
—
077743
MEDICARE
PA
01
—
1543468
PERSONAL CHOICE
PA
01
—
2228304000
KEYSTONE HEALTH PLAN EAST
PA
01
—
3428119
AETNA
PA
01
—
35998
HEALTH PARTNERS
PA
01
—
690613
BLUECROSS
PA
01
—
PHI54368
HIGHMARK
PA
Enumeration date
11/30/2006
Last updated
02/06/2019
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