Organization
ADVANCED PHYSICAL MEDICINE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAE MARIE JACQUELINE VENARUCCI DC (PRESIDENT)
(570) 451-1133
Entity
Organization
Contact information
Practice address
102 N MAIN ST, OLD FORGE, PA 18518-1726
(570) 451-1133
(570) 451-0541
Mailing address
102 N MAIN ST, OLD FORGE, PA 18518-1726
(570) 451-1133
(570) 451-0541
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
08/31/2009
Last updated
08/31/2009
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