=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538086939
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ABBY MARIE ROYER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2026
-----------------------------------------------------
Last Update Date | 07/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 401 N FAIRVIEW ST
-----------------------------------------------------
City | LOCK HAVEN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17745-2390
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-800-0497
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 471 TOWNSHIP LINE RD
-----------------------------------------------------
City | BECHTELSVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19505-9252
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-800-0497
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2255A2300X
-----------------------------------------------------
Taxonomy Name | Athletic Trainer
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------