Provider Demographics
NPI:1326776790
Name:MEDCALF, DAVID AUGUSTINE
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:AUGUSTINE
Last Name:MEDCALF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 YARA WAY
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-8476
Mailing Address - Country:US
Mailing Address - Phone:717-870-8398
Mailing Address - Fax:
Practice Address - Street 1:55 MONUMENT RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5023
Practice Address - Country:US
Practice Address - Phone:717-812-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT030715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist