Organization
BUSTLETON PHYSICAL & SPORTS REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA MARIE GAVARONE DO (OWNER AND PRESIDENT)
(215) 676-7067
Entity
Organization
Contact information
Practice address
9622 BUSTLETON AVE, STE 4, PHILADELPHIA, PA 19115-3100
(215) 677-8258
(215) 673-4966
Mailing address
9622 BUSTLETON AVE, STE 4, PHILADELPHIA, PA 19115-3100
(215) 677-8258
(215) 673-4966
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/08/2006
Last updated
08/22/2020
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