Individual
MRS. VIDETTE R JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
200 2ND AVE, KINGSTON, PA 18704-5722
(570) 288-9315
Mailing address
200 2ND AVE, KINGSTON, PA 18704-5722
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE000554L
PA
Other
Enumeration date
10/07/2008
Last updated
10/07/2008
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