Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT018753 | PA |
Y | 2251N0400X | Physical Therapist - Neurology | PT018753 | PA |
NPI | 1205164365 |
---|---|
Provider Name | Robin Cvitanov |
First Address | Paoli, PA 19301 |
Second Address | Paoli, PA 19301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2009 |
Last Update Date | 11/09/2020 |