Individual
ELIZA HASTIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4250 WISSAHICKON AVE STE 1003, PHILADELPHIA, PA 19129-1215
(267) 519-9209
Mailing address
4250 WISSAHICKON AVE STE 1003, PHILADELPHIA, PA 19129-1215
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT032658
PA
Other
Enumeration date
09/09/2024
Last updated
09/13/2024
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