Individual
DANA ROLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
151 GAYVIEW TER, JOHNSTOWN, PA 15905-5615
(814) 421-6946
Mailing address
207 OTTAWA SR, JOHNSTOWN, PA 15904
(814) 266-8621
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
TEI000186
PA
Other
Enumeration date
05/11/2022
Last updated
05/11/2022
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