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NPI Code Detail

MEDICARE: MRS. LISA MAY ROLAND-FELTY PTA

MEDICARE: MRS. LISA MAY ROLAND-FELTY PTA
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
1225200000XPhysical Therapy AssistantTE000981LPA

General Provider Information

NPI Number : 1770625188
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA MAY ROLAND-FELTY PTA
Provider Business Mailing Address
First Line : 2109 US HIGHWAY 522 S
Second Line :
City : MC VEYTOWN
State : PA
Zip : 17051-9429
Country : US
Telephone Number : 814-542-8630
Fax Number : 814-542-4970
Provider Business Practice Location Address
First Line : 2109 US HIGHWAY 522 S
Second Line :
City : MC VEYTOWN
State : PA
Zip : 17051-9429
Country : US
Telephone Number : 814-542-8630
Fax Number : 814-542-4970
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 07/08/2007

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