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Individual

AVATAR BARLIS SEVERINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
600 RED LION RD APT V9, PHILADELPHIA, PA 19115-1226
(407) 634-9719
Mailing address
600 RED LION RD APT V9, PHILADELPHIA, PA 19115-1226
(407) 634-9719

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1247159
TX
225100000X
Physical Therapist
Primary
PT026426
PA

Other

Enumeration date
11/29/2018
Last updated
11/29/2018
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