Organization
RESTORATION PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ELLEN DOUGHERTY MSPT (PHYSICAL THERAPIST)
(610) 565-0670
Entity
Organization
Contact information
Practice address
203 E BALTIMORE AVENUE, MEDIA, PA 19063-3433
(610) 565-0670
(610) 565-7706
Mailing address
203 E BALTIMORE AVE, MEDIA, PA 19063-3433
(610) 565-0670
(610) 565-7706
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
018385
PA
Other
Enumeration date
12/13/2010
Last updated
06/13/2016
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