Provider Demographics
NPI:1528569886
Name:ROTHERMEL, ERIC EUGENE
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:EUGENE
Last Name:ROTHERMEL
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 1:123 FORSTER ST STE 2
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17102-3430
Mailing Address - Country:US
Mailing Address - Phone:717-232-2068
Mailing Address - Fax:
Practice Address - Street 1:123 FORSTER ST STE 2
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17102-3430
Practice Address - Country:US
Practice Address - Phone:717-232-2068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator