Organization
FUNCTIONAL PHYSICAL THERAPY LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL BENJAMIN VIZAK DPT. (OWNER)
(267) 918-7122
Entity
Organization
Contact information
Practice address
1900 JOHN F KENNEDY BLVD, PHILADELPHIA, PA 19103-1440
(267) 918-7122
Mailing address
38 NAROTHYN RD, SELLERSVILLE, PA 18960-2957
(267) 918-7122
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/19/2020
Last updated
09/19/2020
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