Provider Demographics
NPI:1366250326
Name:PAHLS, GEORGE D
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:D
Last Name:PAHLS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 GERMANTOWN PIKE STE 210
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-7401
Mailing Address - Country:US
Mailing Address - Phone:610-292-8400
Mailing Address - Fax:
Practice Address - Street 1:10030 PARK CEDAR DR STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8901
Practice Address - Country:US
Practice Address - Phone:610-292-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOF000098225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter