Functional Physical Therapy LLC.

Physical Therapist in Philadelphia, PA. Organization (NPI-2).

NPI number1962018440

StatusActive

Last updated in NPPESSep 19, 2020

Details

NPI: 1962018440
Entity type: Organization (NPI-2)
Legal business name: Functional Physical Therapy LLC.
Organization subpart: No
Enumeration date: Sep 19, 2020
Certification date: Sep 19, 2020
Last updated: Sep 19, 2020

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
225100000X	Physical Therapist	–	–	Yes

Practice location

1900 John F Kennedy Blvd
Philadelphia, PA 19103-1440

Phone 267-918-7122

Mailing address

38 Narothyn Rd
Sellersville, PA 18960-2957

Phone 267-918-7122

Authorized official

Daniel Benjamin Vizak
Owner
2679187122

Is something wrong?

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