Healthcare Provider Details

I. General information

NPI: 1497394191
Provider Name (Legal Business Name): YOUNG WOMEN'S CHRISTIAN ASSOCIATON OF GETTYSBURG & ADAMS COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2019
Last Update Date: 12/27/2019
Certification Date: 12/27/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 FAIRFIELD RD
GETTYSBURG PA
17325-7244
US

IV. Provider business mailing address

909 FAIRFIELD RD
GETTYSBURG PA
17325-7244
US

V. Phone/Fax

Practice location:
  • Phone: 717-334-9171
  • Fax:
Mailing address:
  • Phone: 717-334-9171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. MICHAEL DANE DORSETTE
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 717-334-9171