Provider Demographics
NPI:1013153980
Name:MUELLER, NANCY CAROL (PT)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:CAROL
Last Name:MUELLER
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 1:279 HILL RD
Mailing Address - Street 2:
Mailing Address - City:FORKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18616-8705
Mailing Address - Country:US
Mailing Address - Phone:570-924-1022
Mailing Address - Fax:
Practice Address - Street 1:279 HILL RD
Practice Address - Street 2:
Practice Address - City:FORKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18616-8705
Practice Address - Country:US
Practice Address - Phone:570-924-1022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-26
Last Update Date:2008-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT003512L225100000X
GAPT009248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist