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Organization

RISING STARS YOUTH TRAINING.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN UNDERWOOD (PRESIDENT/DIRECTOR)
(272) 770-9700
Entity
Organization

Contact information

Practice address
33 PUBLIC SQ, WILKES BARRE, PA 18701-1701
(272) 770-9700
Mailing address
229 HORTON ST # 31, WILKES BARRE, PA 18702-3434
(272) 770-9700

Taxonomy

Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary

Other

Enumeration date
03/10/2025
Last updated
10/18/2025
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