Provider Demographics
NPI:1144257197
Name:ROULAND, BETHANY LUNDIE (PT)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:LUNDIE
Last Name:ROULAND
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 1:5400 BENSALEM BLVD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-4016
Mailing Address - Country:US
Mailing Address - Phone:215-638-0286
Mailing Address - Fax:
Practice Address - Street 1:805-806 FLORAL VALE BOULEVARD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067
Practice Address - Country:US
Practice Address - Phone:215-968-4901
Practice Address - Fax:215-968-9718
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT001919E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist