Healthcare Provider Details

I. General information

NPI: 1518286491
Provider Name (Legal Business Name): PA EVALUATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2010
Last Update Date: 05/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 6TH ST.
MOUNT GRETNA PA
17064
US

IV. Provider business mailing address

302 6TH ST.
MOUNT GRETNA PA
17064
US

V. Phone/Fax

Practice location:
  • Phone: 717-964-1860
  • Fax: 717-964-3204
Mailing address:
  • Phone: 717-964-1860
  • Fax: 717-964-3204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. BRAD WILLIAM KLEINFELTER
Title or Position: OWNER
Credential:
Phone: 717-964-1860