Provider Demographics
NPI:1922812395
Name:FLATT, JERAD (PT)
Entity type:Individual
Prefix:
First Name:JERAD
Middle Name:
Last Name:FLATT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8460 LIMEKILN PIKE APT 1135
Mailing Address - Street 2:
Mailing Address - City:WYNCOTE
Mailing Address - State:PA
Mailing Address - Zip Code:19095-2660
Mailing Address - Country:US
Mailing Address - Phone:918-685-0579
Mailing Address - Fax:
Practice Address - Street 1:1000 EASTON RD STE 207
Practice Address - Street 2:
Practice Address - City:WYNCOTE
Practice Address - State:PA
Practice Address - Zip Code:19095-2900
Practice Address - Country:US
Practice Address - Phone:215-517-7551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT033018225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist