Provider Demographics
NPI:1356319958
Name:PERRY, JUNE MARIE (PT)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:MARIE
Last Name:PERRY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JUNE
Other - Middle Name:
Other - Last Name:VILLAFRANCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:3916 TRINDLE RD
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4246
Practice Address - Country:US
Practice Address - Phone:717-730-6171
Practice Address - Fax:717-730-7150
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADAPT002704225100000X
PAPT013587L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1021403800001Medicaid