Provider Demographics
NPI:1659636256
Name:BATOON, LARIZA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:LARIZA
Middle Name:
Last Name:BATOON
Suffix:
Gender:F
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 1:189 ORCHARD HILLS DR
Mailing Address - Street 2:APT 104
Mailing Address - City:MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:17058-7266
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:69 COTTAGE RD
Practice Address - Street 2:
Practice Address - City:MIFFLIN
Practice Address - State:PA
Practice Address - Zip Code:17058-7030
Practice Address - Country:US
Practice Address - Phone:717-436-8921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist