Provider Demographics
NPI:1053650317
Name:VARNEY, ALICIA NICHOL (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:NICHOL
Last Name:VARNEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2237 UPPER ROAD
Mailing Address - Street 2:
Mailing Address - City:SHAMOKIN
Mailing Address - State:PA
Mailing Address - Zip Code:17872
Mailing Address - Country:US
Mailing Address - Phone:570-509-2133
Mailing Address - Fax:
Practice Address - Street 1:2237 UPPER RD
Practice Address - Street 2:
Practice Address - City:SHAMOKIN
Practice Address - State:PA
Practice Address - Zip Code:17872-7824
Practice Address - Country:US
Practice Address - Phone:570-509-2133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE1001508225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant