Healthcare Provider Details

I. General information

NPI: 1215972310
Provider Name (Legal Business Name): HENRY H HERSHEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 S BROAD ST
LITITZ PA
17543-2808
US

IV. Provider business mailing address

747 S BROAD ST
LITITZ PA
17543-2808
US

V. Phone/Fax

Practice location:
  • Phone: 717-627-1285
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
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: RHODA CICERO
Title or Position: PRACTICE MANAGER
Credential:
Phone: 717-627-1285