Healthcare Provider Details

I. General information

NPI: 1962485391
Provider Name (Legal Business Name): DELORES JEAN AUMILLER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 08/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 EARLYSTOWN RD
CENTRE HALL PA
16828
US

IV. Provider business mailing address

310 PENN ST SUITE 103
HOLLIDAYSBURG PA
16648-2044
US

V. Phone/Fax

Practice location:
  • Phone: 814-364-3290
  • Fax: 814-364-3295
Mailing address:
  • Phone: 814-695-2923
  • Fax: 814-695-2924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT001950L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: