Provider Demographics
NPI:1609179290
Name:KREIDER, ROBERT GLENN (CMT, BS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:GLENN
Last Name:KREIDER
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Gender:M
Credentials:CMT, BS
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Mailing Address - Street 1:1013 W MAIN ST
Mailing Address - Street 2:SUITE #1
Mailing Address - City:MOUNT JOY
Mailing Address - State:PA
Mailing Address - Zip Code:17552-9699
Mailing Address - Country:US
Mailing Address - Phone:717-367-6224
Mailing Address - Fax:717-823-6382
Practice Address - Street 1:904 DAWN AVE
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1340
Practice Address - Country:US
Practice Address - Phone:717-733-8900
Practice Address - Fax:717-823-6382
Is Sole Proprietor?:No
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist