Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC006103L | PA |
NPI | 1427130244 |
---|---|
Provider Name | Dr. Thomas A Rottet |
First Address | Orwigsburg, PA 17961-9191 |
Second Address | Orwigsburg, PA 17961-9191 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 05/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U55567 | (02) | PA |