Provider Demographics
NPI:1922208131
Name:FARRELL, TODD (CMT)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:FARRELL
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 BENNER PIKE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-8475
Mailing Address - Country:US
Mailing Address - Phone:814-353-9155
Mailing Address - Fax:
Practice Address - Street 1:3208 BENNER PIKE
Practice Address - Street 2:SUITE 130
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-8475
Practice Address - Country:US
Practice Address - Phone:814-353-9155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist