Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | TEI002654 | PA |
NPI | 1003106147 |
---|---|
Provider Name | Janene George |
First Address | Plymouth Meeting, PA 19462-1047 |
Second Address | Plymouth Meeting, PA 19462-1047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2011 |
Last Update Date | 11/04/2011 |