Provider Demographics
NPI:1548555139
Name:LECOMPTE, BEVERLY ANN (PT)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:ANN
Last Name:LECOMPTE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:520 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3902
Mailing Address - Country:US
Mailing Address - Phone:724-463-7478
Mailing Address - Fax:724-463-0931
Practice Address - Street 1:1116 HORSHAM RD
Practice Address - Street 2:SUITE 3
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-1143
Practice Address - Country:US
Practice Address - Phone:215-646-2064
Practice Address - Fax:215-646-2583
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006737L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396749Medicare PIN