MEDICARE: JUSTIN GEISSINGER DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	PT022166	PA

General Provider Information

NPI Number	:	1013278373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN GEISSINGER DPT

Provider Business Mailing Address
First Line	:	314 N MARY ST
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-3329
Country	:	US
Telephone Number	:	717-314-5446
Fax Number	:

Provider Business Practice Location Address
First Line	:	617 N PRINCE ST # A
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-4769
Country	:	US
Telephone Number	:	717-390-4822
Fax Number	:	717-390-4825

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2012
Last Update Date	:	03/13/2013

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