Provider Demographics
NPI:1326015116
Name:THORNE, TIMOTHY DANIEL (OTR/L)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:DANIEL
Last Name:THORNE
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 1:310 LORTZ AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-3416
Mailing Address - Country:US
Mailing Address - Phone:717-446-0055
Mailing Address - Fax:717-446-0145
Practice Address - Street 1:310 LORTZ AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-3416
Practice Address - Country:US
Practice Address - Phone:717-446-0055
Practice Address - Fax:717-446-0145
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010806225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS999/139370ZBMYMedicare PIN