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Organization

DREXEL UNIVERSITY

Active
Other names
Drexel University Physical Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
KEVIN GARD DPT, OCS (ASSOCIATE CHAIR)
(215) 762-7460
Entity
Organization

Contact information

Practice address
245 N 15TH ST # MS 502, PHILADELPHIA, PA 19102-1101
(215) 762-7460
(215) 762-1175
Mailing address
245 N 15TH ST # MS 502, PHILADELPHIA, PA 19102-1101
(215) 762-7460
(215) 762-1175

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT007722L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1127435
FIRST HEALTH
PA
01
30017828
KEYSTONE MERCY HEALTH PLAN
PA
01
3054841
AETNA
PA
01
342212
BC/BS
PA
Enumeration date
05/08/2009
Last updated
05/08/2009
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