Provider Demographics
NPI:1205829777
Name:MARCHETTI, DAVID P JR (ATC, CSCS)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:P
Last Name:MARCHETTI
Suffix:JR
Gender:M
Credentials:ATC, CSCS
Other - Prefix:
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Mailing Address - Street 1:153 DANIELS RD
Mailing Address - Street 2:
Mailing Address - City:HAWLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18428-8242
Mailing Address - Country:US
Mailing Address - Phone:570-208-5900
Mailing Address - Fax:570-208-6016
Practice Address - Street 1:133 N RIVER ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18711-0800
Practice Address - Country:US
Practice Address - Phone:570-208-5900
Practice Address - Fax:570-208-6016
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PART0046482255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer