Individual
MR. EDWARD LEO RISING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
701 SLATE BELT BLVD, BANGOR, PA 18013-9341
(610) 599-1454
Mailing address
396 SLATEFORD RD, MOUNT BETHEL, PA 18343-5514
(570) 897-6815
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP001867L
PA
Other
Enumeration date
07/05/2007
Last updated
07/08/2007
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