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General NPI Number Information
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NPI Number | 1386772150
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Entity Type | Individual
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Provider Name | ROBERT MCCOY WOLF ATC
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Gender | Male
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6746 CARLISLE PIKE
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City | MECHANICSBURG
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State | PA
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Zip | 17050-1711
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Country | US
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Telephone | 717-506-3342
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Fax |
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Provider Business Mailing Address
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Address Line | 1358 HORICK DR
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City | BOILING SPRINGS
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State | PA
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Zip | 17007-9613
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Country | US
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Telephone | 717-249-9370
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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 | RT000647A
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License Number State | PA
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