Provider Demographics
NPI:1144287343
Name:HENRY, JOEL (PT)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:HENRY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S 7TH AVE
Mailing Address - Street 2:STE 3020
Mailing Address - City:WEST READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1410
Mailing Address - Country:US
Mailing Address - Phone:610-375-6147
Mailing Address - Fax:610-378-9967
Practice Address - Street 1:301 S 7TH AVE
Practice Address - Street 2:STE 3020
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1410
Practice Address - Country:US
Practice Address - Phone:610-375-6147
Practice Address - Fax:610-378-9967
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT003334L2251E1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA422693OtherHIGHMARK BLUE SHIELD
PA50029027OtherCAPITAL BLUE CROSS
PA422693QOCMedicare ID - Type Unspecified