MEDICARE: ERIN PLETCHER ATC

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	226300000X	Kinesiotherapist	RT004139	PA
2	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1477877207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN PLETCHER ATC

Provider Business Mailing Address
First Line	:	4201 HENRY AVE
Second Line	:	RONSON HASC 225
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-5409
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4201 HENRY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-5409
Country	:	US
Telephone Number	:	215-951-2721
Fax Number	:

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

Provider Enumeration Date	:	03/23/2010
Last Update Date	:	09/19/2023

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