Provider Demographics
NPI:1558990499
Name:KEISER, HAROLD BENJAMIN
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:BENJAMIN
Last Name:KEISER
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 1:295 COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-7062
Mailing Address - Country:US
Mailing Address - Phone:570-492-0498
Mailing Address - Fax:
Practice Address - Street 1:15 RIDGECREST CIR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-6367
Practice Address - Country:US
Practice Address - Phone:570-492-0498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE12348225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant