Provider Demographics
NPI:1962485391
Name:AUMILLER, DELORES JEAN (PT)
Entity Type:Individual
Prefix:
First Name:DELORES
Middle Name:JEAN
Last Name:AUMILLER
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 1:310 PENN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-2044
Mailing Address - Country:US
Mailing Address - Phone:814-695-2923
Mailing Address - Fax:814-695-2924
Practice Address - Street 1:2825 EARLYSTOWN RD
Practice Address - Street 2:
Practice Address - City:CENTRE HALL
Practice Address - State:PA
Practice Address - Zip Code:16828
Practice Address - Country:US
Practice Address - Phone:814-364-3290
Practice Address - Fax:814-364-3295
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT001950L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA650021213OtherRR MEDICARE
PA743888OtherHIGHMARK
PA031771PRYMedicare ID - Type Unspecified
PA650021213OtherRR MEDICARE