Provider Demographics
NPI:1174606958
Name:LIPPINCOTT, ERIC L (PT, ATC)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:L
Last Name:LIPPINCOTT
Suffix:
Gender:M
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 E BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7038
Mailing Address - Country:US
Mailing Address - Phone:814-571-4767
Mailing Address - Fax:
Practice Address - Street 1:401 SUSQUEHANNA AVENUE
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745
Practice Address - Country:US
Practice Address - Phone:570-893-2781
Practice Address - Fax:570-893-2220
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012885L225100000X
PART001479A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist