Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 0C004132L | PA |
NPI | 1063513562 |
---|---|
Provider Name | David Michael Wolfe |
First Address | Lincoln University, PA 19352-1757 |
Second Address | West Grove, PA 19390-9447 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 08/07/2007 |