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Organization
HCR MANOR CARE
Active
Organization
HCR MANOR CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN L. DERR COTA/L (OCCUPATIONAL THERAPY ASSISTANT)
(570) 320-0477
Entity
Organization
Contact information
Practice address
836 DIAMOND ST, WILLIAMSPORT, PA 17701-4348
(570) 447-3154
Mailing address
836 DIAMOND ST, WILLIAMSPORT, PA 17701-4348
(570) 447-3154
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
OP006518
PA
Other
Enumeration date
10/09/2008
Last updated
10/09/2008
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