PT at Home Physical Therapy and Wellness Solutions LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PT AT HOME PHYSICAL THERAPY AND WELLNESS SOLUTIONS LLC

Practice address

450 Mountain View Rd
Nazareth, PA 18064-9642

Phone

(610) 533-1849

NPI assigned

Jun 1, 2019

Last updated

Jun 1, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Le Angelo A Villaceran, PHYSICAL THERAPIST

Title

Rehab Manager

Phone

(610) 533-1849

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559347200000",
    "number": "1184282402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 MOUNTAIN VIEW RD",
            "city": "NAZARETH",
            "state": "PA",
            "postal_code": "180649642",
            "telephone_number": "610-533-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 MOUNTAIN VIEW RD",
            "city": "NAZARETH",
            "state": "PA",
            "postal_code": "180649642",
            "telephone_number": "610-533-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PT AT HOME PHYSICAL THERAPY AND WELLNESS SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-01",
        "last_updated": "2019-06-01",
        "status": "A",
        "authorized_official_last_name": "VILLACERAN",
        "authorized_official_first_name": "LE ANGELO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "REHAB MANAGER",
        "authorized_official_telephone_number": "610-533-1849",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas John Polanski, DMD
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• Emily Anne Potok, RBT, LBS
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• Harrison Arthur Price
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• Douglas Rankin
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• Jenny Reilly, LPC
• Paul Reuter, PT

• Physical Therapy Clinic/Center in Nazareth, PA
• Providers in Nazareth, PA by specialty
• Physical Therapy Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.