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General NPI Number Information
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NPI Number | 1467070839
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Entity Type | Individual
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Provider Name | MORGAN BROCKMAN
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Gender | Female
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Dates
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Enumeration Date | 07/11/2020
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 2998 LUTHER DR
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City | CHAMBERSBURG
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State | PA
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Zip | 17202-8131
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Country | US
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Telephone | 717-414-0908
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Fax |
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Provider Business Mailing Address
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Address Line | 163 N BLACKBERRY LN
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City | FAYETTEVILLE
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State | PA
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Zip | 17222-9362
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Country | US
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Telephone | 717-414-0908
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OC016968
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License Number State | PA
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