Individual
GERALD JOHN VITALE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA, DPT
Contact information
Practice address
64 RIDGWAY DR STE 1, DALLAS, PA 18612-9263
(570) 675-1866
Mailing address
PO BOX 1083, KINGSTON, PA 18704
(570) 332-9276
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
Other
Enumeration date
02/02/2022
Last updated
02/03/2022
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