Individual
MRS. JEAN M DIVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 CHANDRA DR, DUNCANNON, PA 17020-9745
(717) 834-4111
(717) 834-6332
Mailing address
RR 3 BOX 1315B, MIFFLINTOWN, PA 17059
(717) 436-9869
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE000015L
PA
Other
Enumeration date
07/03/2007
Last updated
07/08/2007
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