Ellen Janette Goodheer

Individual provider Active NPI Physical Therapy Assistant · Muncy, PA

NPI 1255786232 · NPPES record last updated May 4, 2016

Key facts

NPI
1255786232
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
TE101880 (PA)
Practice address
215 E Water St
Muncy, PA 17756-8828
Phone
(570) 546-8282
NPI assigned
Apr 27, 2016
Sex
Female
Sole proprietor
Yes

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
TE101880PAMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TE101880 PA Yes

Addresses

Primary practice location

215 E Water St
Muncy, PA 17756-8828

Mailing address

1400 Campbell St
Williamsport, PA 17701-3043
Phone (717) 636-2315

Other providers in Muncy, PA

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

Sources for this page

Verify at the official NPI Registry.