Jody Detweiler, PTA

Individual provider Active NPI Physical Therapy Assistant · Seven Fields, PA

NPI 1194069674 · NPPES record last updated Nov 21, 2012

Key facts

NPI
1194069674
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
TE1002850 (PA)
Practice address
200 Northpointe Cir
Suite 302
Seven Fields, PA 16046-7861
Phone
(215) 257-2751
NPI assigned
Nov 21, 2012
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
TE1002850PAMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TE1002850 PA Yes

Addresses

Primary practice location

200 Northpointe Cir
Suite 302
Seven Fields, PA 16046-7861

Mailing address

1930 Upper Ridge Rd
Green Lane, PA 18054-9418

Other providers in Seven Fields, PA

All providers in Seven Fields, PA · Physical Therapy Assistant in Pennsylvania

Sources for this page

Verify at the official NPI Registry.