Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics |
NPI | 1053801407 |
---|---|
Provider Name | Eric Jeffrey Foley |
First Address | Williamsport, PA 17701-1613 |
Second Address | Montoursville, PA 17754-9621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2018 |
Last Update Date | 11/05/2018 |