| Justin James Depermentier, PT, DPT, ATC | |
|
450 Park Way, Suite A, Broomall, PA 19008-4202 | |
| (610) 355-1780 | |
| (484) 428-3813 |
| Full Name | Justin James Depermentier |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 450 Park Way, Broomall, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629461868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 070.022242 (Illinois) | Secondary |
| 225100000X | Physical Therapist | PT024201 (Pennsylvania) | Primary |
| Provider Name | Premier Orthopaedic And Sports Medicine Associates, Ltd |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1215987243 PECOS PAC ID: 5890681092 Enrollment ID: O20040225000221 |
| Provider Name | Pennsylvania Luna Care Physical Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1528689445 PECOS PAC ID: 7012338973 Enrollment ID: O20200601001529 |
| Mailing Address | Practice Location Address |
|---|---|
| Justin James Depermentier, PT, DPT, ATC 450 Park Way, Suite 300, Broomall, PA 19008-4202 Ph: (484) 422-8080 | Justin James Depermentier, PT, DPT, ATC 450 Park Way, Suite A, Broomall, PA 19008-4202 Ph: (610) 355-1780 |
Nicole Flynn, DPT, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 146 Marple Rd, Broomall, PA 19008 Phone: 610-356-0100 | |
Mr. Leslie Robert Dorf, P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: 419 Lawrence Rd, Broomall, PA 19008 Phone: 610-353-2606 Fax: 610-353-5963 | |
Mrs. Julie Carol Madonna, M.S.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 419 Lawrence Rd, Broomall, PA 19008 Phone: 610-353-2800 | |
Mrs. Jennifer Lee O'gara, MPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2004 Sproul Rd, Broomall, PA 19008 Phone: 610-359-1580 Fax: 610-359-1050 | |
Jamie Rosenberg, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2506 Grant Rd, Broomall, PA 19008 Phone: 484-368-1589 | |
Ryan Michael Scheller, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 580 Reed Rd, Suite #3, Broomall, PA 19008 Phone: 610-356-6211 | |
Joseph Crawford, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 580 Reed Rd Ste 3, Broomall, PA 19008 Phone: 610-356-6211 |