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Provider Information for 1730329087

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Gender: FEMALE

Individual NPI: 1730329087

Calendar   Last Updated:  2018-03-17
  Certification Date: 


Name Value
NPI 1730329087
Enumeration Date 2009-02-26
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 81 FISH RD
WELLSBORO, PA 16901-6913
United States

Phone: 610-914-3884 | Fax:
View Map External Link
Primary Practice Address 416 S MAIN ST
MANSFIELD, PA 16933-1510
United States

Phone: 570-662-1900 | Fax:
View Map External Link
Secondary Practice Address 1040 LIGGETT AVE
READING, PA 19611-1801
United States

Phone: 610-775-1431 | Fax:
View Map External Link

Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 225100000X - Physical Therapist PA PT018882