Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MSG000336 | PA |
N | 226300000X | Kinesiotherapist | 217043 | PA |
NPI | 1477850766 |
---|---|
Provider Name | Mr. Jeffrey Fuchs |
First Address | Richboro, PA 18954-1223 |
Second Address | Richboro, PA 18954-1223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2011 |
Last Update Date | 22/02/2011 |