Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT003652L | PA |
NPI | 1053318816 |
---|---|
Provider Name | Mr. Stephen Francis Hetzel |
First Address | Reading, PA 19607-9764 |
Second Address | Reading, PA 19604-1539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 08/07/2007 |