# AQUAHAB, LP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AQUAHAB PHYSICAL THERAPY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679718191
- **Authorized official:** DEBORAH SIEDLECKI (BILLING SUPERVISOR)
- **Authorized official phone:** (215) 677-0400

## Contact information

- **Practice address:** 3600 GRANT AVE, PHILA, PA 19114-2630
- **Practice address phone:** (215) 677-0400
- **Practice address fax:** (215) 671-1837
- **Mailing address:** 3600 GRANT AVE, PHILA, PA 19114-2630
- **Mailing address phone:** (215) 677-0400
- **Mailing address fax:** (215) 671-1837

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133NN1002X | Nutrition Education Nutritionist | DN002660 | PA | Yes |
| 133NN1002X | Nutrition Education Nutritionist | DN003739 | PA | — |
| 133NN1002X | Nutrition Education Nutritionist | DN003889 | PA | — |

## Other

- **Enumeration date:** 12/12/2008
- **Last updated:** 12/12/2008