Provider Demographics
NPI:1164675872
Name:STROBEL, BERNARD C (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:C
Last Name:STROBEL
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ABBEY LN
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:PA
Mailing Address - Zip Code:18644-9100
Mailing Address - Country:US
Mailing Address - Phone:570-262-2617
Mailing Address - Fax:
Practice Address - Street 1:1548 SANS SOUCI PKWY
Practice Address - Street 2:
Practice Address - City:HANOVER TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18706-6028
Practice Address - Country:US
Practice Address - Phone:570-829-5670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-25
Last Update Date:2008-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC003209L261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation