Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT023402 | PA |
NPI | 1356966840 |
---|---|
Provider Name | John Giampietro |
First Address | Mountain Top, PA 18707-9589 |
Second Address | Kingston, PA 18704-3701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2020 |
Last Update Date | 10/06/2020 |