Organization
DEBRA A STATES OTR/L CLT MFRP
Active
Organization
DEBRA A STATES OTR/L CLT MFRP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA A STATES (OWNER/OCCUPATIONAL THERAPIST)
(814) 658-3498
Entity
Organization
Contact information
Practice address
15428 RAYSTOWN RD, JAMES CREEK, PA 16657-8705
(814) 658-3498
(814) 658-3498
Mailing address
15428 RAYSTOWN RD, JAMES CREEK, PA 16657-8705
(814) 658-3498
(814) 658-3498
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC008293
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012091580001
—
PA
Enumeration date
02/18/2014
Last updated
11/19/2014
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