Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT016897 | PA |
NPI | 1427682269 |
---|---|
Provider Name | Vanessa Marciello |
First Address | Sellersville, PA 18960-3324 |
Second Address | Quakertown, PA 18951-1085 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2020 |
Last Update Date | 02/03/2020 |