Individual
DORENE A DECECCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
100 S FIRST STREET, STE B, MILLERSBURG, PA 17061-1501
(717) 692-4708
(717) 692-5464
Mailing address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
DAPT003710
PA
225100000X
Physical Therapist
Primary
PT006466L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019288100036
—
PA
01
—
782491
MEDICARE
PA
Enumeration date
07/02/2006
Last updated
04/27/2020
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