Provider Demographics
NPI:1083853857
Name:GOBER, LIZABETH (MPT)
Entity Type:Individual
Prefix:
First Name:LIZABETH
Middle Name:
Last Name:GOBER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 DERRY ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3576
Mailing Address - Country:US
Mailing Address - Phone:717-839-2110
Mailing Address - Fax:717-565-1934
Practice Address - Street 1:755 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT JOY
Practice Address - State:PA
Practice Address - Zip Code:17552-9510
Practice Address - Country:US
Practice Address - Phone:717-653-0323
Practice Address - Fax:717-653-0527
Is Sole Proprietor?:No
Enumeration Date:2009-02-18
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009936L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA391895R9XMedicare Oscar/Certification