MEDICARE: WARNER PEDIATRIC THERAPY

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	252Y00000X	Early Intervention Provider Agency	OC000360L	PA

General Provider Information

NPI Number	:	1730425638
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WARNER PEDIATRIC THERAPY

Provider Business Mailing Address
First Line	:	4224 GREYWOOD DR
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-7222
Country	:	US
Telephone Number	:	717-870-9641
Fax Number	:	717-840-8199

Provider Business Practice Location Address
First Line	:	4224 GREYWOOD DR
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-7222
Country	:	US
Telephone Number	:	717-870-9641
Fax Number	:	717-840-8199

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. MONICA WARNER
Credential	:	OTR/L
Telephone Number	:	717-870-9641

Provider Enumeration Date	:	12/20/2012
Last Update Date	:	12/20/2012

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