Individual
MR. CHARLES E HEADLEY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
75 HICKLE ST, UNIONTOWN, PA 15401-4350
(724) 437-9871
Mailing address
PO BOX 72, 456 1ST ST., VESTABURG, PA 15368-0072
(412) 999-1924
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI002097
PA
Other
Enumeration date
01/18/2010
Last updated
01/18/2010
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