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Individual

REGINALD DELAINE COLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA, MSW, LSW

Contact information

Practice address
312 HOBART ST, GORDON, PA 17936
(570) 640-8478
Mailing address
615 CUMBERLAND ST, LEBANON, PA 17042-5233
(717) 270-6972

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW140786
PA
225200000X
Physical Therapy Assistant
TEI000078
PA

Other

Enumeration date
08/06/2009
Last updated
01/24/2024
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