Healthcare Provider Details

I. General information

NPI: 1376769414
Provider Name (Legal Business Name): LAWRENCE PAUL GEIER PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 HICKORY RD SUITE 240
PLYMOUTH MEETING PA
19462-1047
US

IV. Provider business mailing address

150 BRIARWOOD DR
PITTSBURGH PA
15235-4301
US

V. Phone/Fax

Practice location:
  • Phone: 800-879-4471
  • Fax:
Mailing address:
  • Phone: 412-241-5864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTE007444
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: