Organization
PIVOT PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW A PETRUCCELLI II PT, DPT, SCS, OCS (PHYSICAL THERAPIST/CLINIC DIRECTOR)
(302) 504-6195
Entity
Organization
Contact information
Practice address
4512 KIRKWOOD HWY, STE. 303, WILMINGTON, DE 19808-5123
(302) 504-6195
(302) 504-6194
Mailing address
4512 KIRKWOOD HWY, STE. 303, WILMINGTON, DE 19808-5123
(302) 504-6195
(302) 504-6194
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
J1-0003344
DE
Other
Enumeration date
07/20/2015
Last updated
07/20/2015
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