Healthcare Provider Details

I. General information

NPI: 1740733054
Provider Name (Legal Business Name): EMILY HAFER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY FUERTSCH

II. Dates (important events)

Enumeration Date: 08/03/2016
Last Update Date: 04/18/2022
Certification Date: 04/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 SAINT LAWRENCE AVE
READING PA
19606-2233
US

IV. Provider business mailing address

2950 SAINT LAWRENCE AVE
READING PA
19606-2233
US

V. Phone/Fax

Practice location:
  • Phone: 484-577-4549
  • Fax:
Mailing address:
  • Phone: 570-351-2604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT025488
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT025488
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: