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General NPI Number Information
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NPI Number | 1144985425
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Entity Type | Individual
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Provider Name | ZANE OBRIEN
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Gender | Male
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Dates
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Enumeration Date | 11/02/2021
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Last Update Date | 11/02/2021
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Provider Practice Location Address
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Address Line | 339 E JAMESTOWN RD
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City | GREENVILLE
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State | PA
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Zip | 16125-9206
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Country | US
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Telephone | 724-588-7610
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Fax |
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Provider Business Mailing Address
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Address Line | 290 N PERRY HWY
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City | MERCER
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State | PA
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Zip | 16137-5038
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Country | US
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Telephone |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | TEI006092
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License Number State | PA
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