Provider Demographics
NPI:1891925244
Name:HERSICK, JOANNA F (PT)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:F
Last Name:HERSICK
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 1:516 JAMISON AVE
Mailing Address - Street 2:
Mailing Address - City:ELLWOOD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16117-2590
Mailing Address - Country:US
Mailing Address - Phone:724-758-7044
Mailing Address - Fax:724-758-3126
Practice Address - Street 1:516 JAMISON AVE
Practice Address - Street 2:
Practice Address - City:ELLWOOD CITY
Practice Address - State:PA
Practice Address - Zip Code:16117-2590
Practice Address - Country:US
Practice Address - Phone:724-758-7044
Practice Address - Fax:724-758-3126
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-011978L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist