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Individual

JODY DETWEILER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
200 NORTHPOINTE CIR, SUITE 302, SEVEN FIELDS, PA 16046-7861
(215) 257-2751
Mailing address
1930 UPPER RIDGE RD, GREEN LANE, PA 18054-9418

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE1002850
PA

Other

Enumeration date
11/21/2012
Last updated
11/21/2012
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