Provider Demographics
NPI:1134335276
Name:EARLEY, JOANNA ROSE (PT)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:ROSE
Last Name:EARLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 SHIRLEY LN
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-2868
Mailing Address - Country:US
Mailing Address - Phone:215-453-0615
Mailing Address - Fax:
Practice Address - Street 1:1403 SHIRLEY LN
Practice Address - Street 2:
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-2868
Practice Address - Country:US
Practice Address - Phone:215-453-0615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT003017E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist