Individual
MR. CHARLES CARTER ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2010 ADAMS AVE, SCRANTON, PA 18509-1508
(570) 963-1278
(570) 963-1292
Mailing address
2010 ADAMS AVE, SCRANTON, PA 18509-1508
(570) 963-1278
(570) 963-1292
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT005879L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001756902004
—
PA
Enumeration date
10/02/2006
Last updated
07/08/2007
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