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NPI Code Detail

MEDICARE: MR. ALDWIN JACOT BALHON RPT

MEDICARE: MR. ALDWIN JACOT BALHON RPT
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 TherapistPT018568PA

General Provider Information

NPI Number : 1598445777
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALDWIN JACOT BALHON RPT
Provider Business Mailing Address
First Line : 6114 SPRING KNOLL DR
Second Line :
City : HARRISBURG
State : PA
Zip : 17111-4869
Country : US
Telephone Number : 484-985-0501
Fax Number :
Provider Business Practice Location Address
First Line : 800 KING RUSS RD
Second Line :
City : HARRISBURG
State : PA
Zip : 17109-5101
Country : US
Telephone Number : 717-657-1520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2023
Last Update Date : 07/21/2023

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