Provider Demographics
NPI:1609077254
Name:COYLE, ERIN MARIE (PT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:COYLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 SHOLLY DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5841
Mailing Address - Country:US
Mailing Address - Phone:717-975-0611
Mailing Address - Fax:717-975-0839
Practice Address - Street 1:124 SHOLLY DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-5841
Practice Address - Country:US
Practice Address - Phone:717-795-8118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT010672L2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001927572 0002OtherMEDICAL ASSISTANCE