Individual
ALEXANDER JOHN PONIKTERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, EMT-B
Contact information
Practice address
1705 NARROWS HILL RD, UPPER BLACK EDDY, PA 18972-9712
(610) 603-6126
Mailing address
1705 NARROWS HILL RD, UPPER BLACK EDDY, PA 18972-9712
(610) 603-6126
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
191326
PA
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/11/2018
Last updated
12/11/2018
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