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General NPI Number Information
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NPI Number | 1083673602
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Entity Type | Organization
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Legal Business Name | PAUL L. KIEFFER
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 08/15/2008
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Provider Practice Location Address
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Address Line | 1372 N SUSQUEHANNA TRL SUITE 250
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City | SELINSGROVE
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State | PA
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Zip | 17870-8971
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Country | US
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Telephone | 570-743-4000
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Fax | 570-743-3105
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Provider Business Mailing Address
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Address Line | 1372 N SUSQUEHANNA TRL SUITE 250
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City | SELINSGROVE
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State | PA
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Zip | 17870-8971
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Country | US
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Telephone | 570-743-4000
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Fax | 570-743-3105
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Authorized Official
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Title or Position | OWNER
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Name | MR. PAUL LESLIE KIEFFER
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Credential | P.T.
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Telephone | 570-743-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT003918L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT016781
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License Number State | PA
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