Organization
SPORTS AND BACK PT LLC
Active
Other names
Sports and Back Rehabiliation
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELINE M BORMAN (CEO)
(215) 752-4553
Entity
Organization
Contact information
Practice address
370 E MAPLE AVE, SUITE 103, LANGHORNE, PA 19047-2859
(215) 752-4553
(215) 752-0703
Mailing address
370 E MAPLE AVE, SUITE 103, LANGHORNE, PA 19047-2859
(215) 752-4553
(215) 752-0703
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
08/30/2012
Last updated
08/30/2012
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