Organization
AQUATIC THERAPY OF CHINATOWN
Active
Organization
AQUATIC THERAPY OF CHINATOWN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARD STAVROPOLSKIY MD (PHYSICAL THERAPY/OWNER)
(215) 574-9388
Entity
Organization
Contact information
Practice address
933 SPRING ST, PHILADELPHIA, PA 19107-1815
(215) 574-9388
(215) 574-9188
Mailing address
7300 BRUCE DRIVE, HOLLAND, PA 18966
(215) 703-3275
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT015799
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2155332000
KEYSTONE HEALTH PLAN EAST
PA
Enumeration date
06/28/2006
Last updated
08/22/2020
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