Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT020663 | PA |
NPI | 1003127663 |
---|---|
Provider Name | Silke H Reddington |
First Address | Scranton, PA 18503-1549 |
Second Address | Blakely, PA 18447-2504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2010 |
Last Update Date | 29/06/2010 |