John Scott Blake, PTA

Individual provider Active NPI Physical Therapy Assistant · Waynesboro, PA

NPI 1114058401 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1114058401
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
TE007725 (PA)
Practice address
501 E Main St
Waynesboro Hospital - Physical Medicine Department
Waynesboro, PA 17268-2353
Phone
(717) 765-4000
Fax
(717) 765-3489
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
TE007725PAMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TE007725 PA Yes

Addresses

Primary practice location

501 E Main St
Waynesboro Hospital - Physical Medicine Department
Waynesboro, PA 17268-2353

Mailing address

129 Prices Church Rd
Waynesboro, PA 17268-9668
Phone (717) 765-4000

Other providers in Waynesboro, PA

All providers in Waynesboro, PA · Physical Therapy Assistant in Pennsylvania

Sources for this page

Verify at the official NPI Registry.