Individual
MR. EDWARD J O MARA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
992 OLD EAGE SCHOOL RD, SUITE 919, WAYNE, PA 19087
(610) 687-2776
(610) 687-2779
Mailing address
947 IVYCROFT RD, WAYNE, PA 19087
(484) 432-8654
(610) 687-2779
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
DAPT0011118
PA
225100000X
Physical Therapist
Primary
PT011430L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0758283000
IBC
—
01
—
976930
HIGHMK
—
Enumeration date
11/29/2006
Last updated
07/08/2007
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