Jane Fagan, PT

Individual provider Active NPI Physical Therapist · Flourtown, PA

NPI 1104926336 · NPPES record last updated Jan 31, 2012

Key facts

NPI
1104926336
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT020279 (PA)
Practice address
1600 Bethlehem Pike
Flourtown, PA 19031-2026
Phone
(215) 233-9677
Fax
(215) 233-9498
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Wallace & Nilan Physical Therapy and Fitness, LLC Physical Therapist Past
since May 21, 2011
Accepting new patients
Progress Physical Therapy LLC Physical Therapist Past
since Jun 22, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7644 TN
Physical Therapist 225100000X PT020279 PA Yes

Addresses

Primary practice location

1600 Bethlehem Pike
Flourtown, PA 19031-2026

Mailing address

1600 Bethlehem Pike
Flourtown, PA 19031-2026
Phone (215) 233-9677

Other providers in Flourtown, PA

All providers in Flourtown, PA · Physical Therapist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.