Individual
BRIANNE PETERSON LATTANZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2813 INDUSTRIAL PARK RD, SUITE 3, MIFFLINTOWN, PA 17059-9078
(717) 436-6042
(717) 436-6264
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
DAPT003073
PA
225100000X
Physical Therapist
Primary
PT021931
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1026991420001
—
PA
Enumeration date
04/09/2012
Last updated
02/28/2019
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