Organization
GENESIS REHAB SERVICES
Active
Other names
SCHUYLKILL MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DARCIE NAN ROEDER (PHY. THERAPY ASSISTANT)
(570) 621-7432
Entity
Organization
Contact information
Practice address
14 KIEHNER RD, SCHUYLKILL HAVEN, PA 17972-8999
(570) 739-4526
Mailing address
14 KIEHNER RD, SCHUYLKILL HAVEN, PA 17972-8999
(570) 739-4526
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
TE1000270
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TE1000270
PT ASSISTANT PENNSYLVANIA STATE LICENSE
PA
Enumeration date
03/25/2011
Last updated
03/25/2011
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