Individual
MR. DANIEL RAY THRUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, PA-C
Contact information
Practice address
500 UNIVERSITY DR, MC A410, HERSHEY, PA 17033-2360
(800) 243-1455
(717) 531-3708
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
RT003024
PA
363A00000X
Physician Assistant
MA054393
PA
363AS0400X
Surgical Physician Assistant
Primary
MA054393
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1032836730001
—
PA
Enumeration date
06/16/2006
Last updated
11/22/2019
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