Provider Demographics
NPI:1457659245
Name:EBERLING, CHARLES LLOYD (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:LLOYD
Last Name:EBERLING
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 W NEWPORT RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-7774
Mailing Address - Country:US
Mailing Address - Phone:717-625-1341
Mailing Address - Fax:
Practice Address - Street 1:6 W NEWPORT RD
Practice Address - Street 2:SUITE 4
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-7774
Practice Address - Country:US
Practice Address - Phone:717-625-1341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist