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Individual

MR. PETER LAWRENCE FATH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MED, ATC

Contact information

Practice address
414 COMMERCE DR, FORT WASHINGTON, PA 19034-2618
(215) 641-0700
Mailing address
3401 N BROAD ST, TEMPLE ORTHOPAEDICS, 6TH FLOOR OUTPATIENT BUILDING, PHILADELPHIA, PA 19140-5103

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003627
PA

Other

Enumeration date
07/19/2007
Last updated
07/19/2007
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