Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | TEI004041 | PA |
NPI | 1013543305 |
---|---|
Provider Name | Desiree Morich |
First Address | Uniontown, PA 15401-3253 |
Second Address | Uniontown, PA 15401-3253 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2020 |
Last Update Date | 18/03/2020 |