Individual
MR. TIMOTHY DREVNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT,OCS,ATC,CSCS
Contact information
Practice address
700 EDEN RD, LANCASTER, PA 17601-4700
(717) 569-4184
(717) 569-4192
Mailing address
160 N POINTE BLVD, SUITE 113, LANCASTER, PA 17601-4134
(717) 569-4184
(717) 569-4192
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
RT000203A
PA
2251X0800X
Orthopedic Physical Therapist
Primary
PT003023L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
415471
HEALTHAMERICA/ASSURANCE
PA
01
—
50057091
BLUE CROSS AND KEYSTONE
PA
01
—
9415781
PHCS
PA
Enumeration date
06/05/2006
Last updated
06/07/2022
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