Healthcare Provider Details

I. General information

NPI: 1285695197
Provider Name (Legal Business Name): BRIAN DAVID HARTZ DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 02/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGHLANDS DR HARTZ PHYSICAL THERAPY STE 100
LITITZ PA
17543
US

IV. Provider business mailing address

100 HIGHLANDS DR STE 100
LITITZ PA
17543
US

V. Phone/Fax

Practice location:
  • Phone: 717-625-2228
  • Fax: 717-625-0959
Mailing address:
  • Phone: 717-625-2228
  • Fax: 717-625-0959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT011889L
License Number StatePA

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: