Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT017124 | PA |
NPI | 1003129321 |
---|---|
Provider Name | Jodi Stiner |
First Address | Indiana, PA 15701-3902 |
Second Address | Williamsport, PA 17701-3908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2010 |
Last Update Date | 15/07/2010 |