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General NPI Number Information
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NPI Number | 1033758958
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Entity Type | Individual
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Provider Name | GEORGE FRANK SALVATERRA PHD
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Gender | Male
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Dates
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Enumeration Date | 12/23/2019
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Last Update Date | 12/23/2019
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Provider Practice Location Address
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Address Line | 160 NELSON FIELDHOUSE
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City | BLOOMSBURG
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State | PA
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Zip | 17815-1301
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Country | US
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Telephone | 507-389-5387
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Fax | 570-389-5006
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Provider Business Mailing Address
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Address Line | 629 NELSON RD
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City | BELLEFONTE
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State | PA
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Zip | 16823
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Country | US
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Telephone | 814-777-0773
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT000316A
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License Number State | PA
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