Healthcare Provider Details

I. General information

NPI: 1427291566
Provider Name (Legal Business Name): REGINA LOIS MARKLE CREDIFIED ROLFER,CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2009
Last Update Date: 04/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 PINE ST
JACOBUS PA
17407-1214
US

IV. Provider business mailing address

13 PINE ST
JACOBUS PA
17407-1214
US

V. Phone/Fax

Practice location:
  • Phone: 717-428-3545
  • Fax:
Mailing address:
  • Phone: 717-428-3545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number30137500 NCTMB
License Number StateMD

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: