Monica Elizabeth Anderson, LAT, ATC, CES

Individual provider Active NPI Athletic Trainer · Williamsport, PA

NPI 1215068382 · NPPES record last updated Jan 17, 2017

Key facts

NPI
1215068382
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
RT004108 (PA)
Practice address
2990 W 4TH St
Williamsport, PA 17701-4197
Phone
(570) 327-5500
NPI assigned
Mar 8, 2007
Sex
Female
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
RT004108PAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT004108 PA Yes

Addresses

Primary practice location

2990 W 4TH St
Williamsport, PA 17701-4197

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900

Other providers in Williamsport, PA

All providers in Williamsport, PA · Athletic Trainer in Pennsylvania

Sources for this page

Verify at the official NPI Registry.