Healthcare Provider Details

I. General information

NPI: 1790827459
Provider Name (Legal Business Name): BONNIE K ZEIS PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 N 7TH ST CHAMBERSBURG HOSPITAL- PHYSICAL MEDICINE
CHAMBERSBURG PA
17201-1720
US

IV. Provider business mailing address

6 STARLIGHT DR
GREENCASTLE PA
17225-1700
US

V. Phone/Fax

Practice location:
  • Phone: 717-267-7715
  • Fax: 717-267-7463
Mailing address:
  • Phone: 717-597-7226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTE001233L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: