Provider Demographics
NPI:1346866142
Name:SCANDALE, JOSEPH JR (LMT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SCANDALE
Suffix:JR
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-2945
Mailing Address - Country:US
Mailing Address - Phone:724-825-1376
Mailing Address - Fax:724-240-3885
Practice Address - Street 1:110 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-2945
Practice Address - Country:US
Practice Address - Phone:724-825-1376
Practice Address - Fax:724-240-3885
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG001552225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist