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Individual

PETER LY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2069 MERCY ST, PHILADELPHIA, PA 19145-2806
(267) 269-9288
Mailing address
3419 TUSCANY DR, PHILADELPHIA, PA 19145-5729
(267) 269-9288

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT029077
PA
2251X0800X
Orthopedic Physical Therapist
Primary
PT029077
PA

Other

Enumeration date
01/19/2021
Last updated
05/19/2022
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