Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT-008783-L | PA |
NPI | 1295926095 |
---|---|
Provider Name | Mrs. Amy B Harper |
First Address | Wallingford, PA 19086-6108 |
Second Address | Wallingford, PA 19086-6332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2007 |
Last Update Date | 06/08/2007 |