Organization
PEDIATRIC THERAPY SPECIALISTS OF SOUTH CENTRAL PA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA MIRACLE OTR/L (OWNER/ OCCUPATIONAL THERAPIST)
(717) 816-0742
Entity
Organization
Contact information
Practice address
2316 OCRACOKE ISLAND CT, CHAMBERSBURG, PA 17202-7422
(717) 816-0742
Mailing address
2316 OCRACOKE ISLAND CT, CHAMBERSBURG, PA 17202-7422
(717) 816-0742
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OC004139L
PA
252Y00000X
Early Intervention Provider Agency
Primary
OC004139L
PA
Other
Enumeration date
07/25/2012
Last updated
07/27/2012
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