Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OP007479 | PA |
NPI | 1003576737 |
---|---|
Provider Name | Daniel Eugene Kolb |
First Address | Camp Hill, PA 17011-8319 |
Second Address | Harrisburg, PA 17109-5317 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2021 |
Last Update Date | 21/12/2021 |