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NPI Code Detail

MEDICARE: MR. LOGAN J. ZEITLER MS, OTR/L

MEDICARE: MR. LOGAN J. ZEITLER MS, OTR/L
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
1225X00000XOccupational TherapistOC014541PA

General Provider Information

NPI Number : 1033665930
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LOGAN J. ZEITLER MS, OTR/L
Provider Business Mailing Address
First Line : 200 PENNSYLVANIA AVE
Second Line :
City : SHENANDOAH
State : PA
Zip : 17976-1332
Country : US
Telephone Number : 570-462-1921
Fax Number :
Provider Business Practice Location Address
First Line : 200 PENNSYLVANIA AVE
Second Line :
City : SHENANDOAH
State : PA
Zip : 17976-1332
Country : US
Telephone Number : 570-462-1921
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2016
Last Update Date : 08/30/2016

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