Brenda Lee Archer, PTA

Individual provider Active NPI Physical Therapy Assistant · Pottsville, PA

NPI 1386960508 · NPPES record last updated Apr 13, 2010

Key facts

NPI
1386960508
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
TE1000199 (PA)
Practice address
1510 Highway 61 South
Pottsville, PA 17901-8409
Phone
(570) 385-5522
NPI assigned
Apr 13, 2010
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
TE1000199PAMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TE1000199 PA Yes

Addresses

Primary practice location

1510 Highway 61 South
Pottsville, PA 17901-8409

Mailing address

1498 Mountain Rd
Pine Grove, PA 17963-8695
Phone (570) 449-8205

Other providers in Pottsville, PA

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

Sources for this page

Verify at the official NPI Registry.