Individual
IAN MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1608 WALNUT ST STE 200, PHILADELPHIA, PA 19103-5426
(155) 458-7172
(215) 545-9355
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT031566
PA
Other
Enumeration date
06/22/2023
Last updated
08/14/2023
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