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NPI Code Detail

MEDICARE: MARIA NICOLE DENNIS PHYSICAL THERAPIST

MEDICARE: MARIA NICOLE DENNIS PHYSICAL THERAPIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT017009PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11749703OTHERPAHIGHMARK

General Provider Information

NPI Number : 1558343731
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA NICOLE DENNIS PHYSICAL THERAPIST
Provider Business Mailing Address
First Line : 300 E PLANK RD
Second Line :
City : ALTOONA
State : PA
Zip : 16602-4154
Country : US
Telephone Number : 814-941-7708
Fax Number : 814-941-7715
Provider Business Practice Location Address
First Line : 105 NASON DR
Second Line :
City : ROARING SPRING
State : PA
Zip : 16673-1202
Country : US
Telephone Number : 814-224-6214
Fax Number : 814-224-6240
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2005
Last Update Date : 07/08/2007

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Directions to “ MARIA NICOLE DENNIS PHYSICAL THERAPIST” Practice Location

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