Individual
MIRANDA ROSE FORTENBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
940 WALNUT BOTTOM RD, CARLISLE, PA 17015-6926
(717) 249-0085
Mailing address
790 GINGRICH LN, DAUPHIN, PA 17018-9743
(717) 440-6066
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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