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General NPI Number Information
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NPI Number | 1922116821
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Entity Type | Individual
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Provider Name | JOANNE KLISS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 55 MILLER ST
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City | SUMMERDALE
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State | PA
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Zip | 17093-0489
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Country | US
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Telephone | 717-732-8400
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Fax | 717-732-8414
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Provider Business Mailing Address
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Address Line | 436 PHEASANT RD
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City | HUMMELSTOWN
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State | PA
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Zip | 17036-7426
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Country | US
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Telephone | 717-469-7185
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 0C000706L
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License Number State | PA
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