Provider Demographics
NPI:1235130949
Name:HITCHENS, BRUCE ALAN (PT)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:ALAN
Last Name:HITCHENS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-2923
Mailing Address - Country:US
Mailing Address - Phone:717-263-5147
Mailing Address - Fax:717-263-3454
Practice Address - Street 1:1007 WAYNE AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2923
Practice Address - Country:US
Practice Address - Phone:717-263-5147
Practice Address - Fax:717-263-3454
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADAPT000741225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001606511Medicaid
PA048658GMFMedicare PIN