| NPI | 1386102002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA GARDNER Manager Payer & Provider Enrollment 717-839-2156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2019-03-12 |