Provider Demographics
NPI:1265745319
Name:MISSIMER, ARIANNE (DPT)
Entity type:Individual
Prefix:DR
First Name:ARIANNE
Middle Name:
Last Name:MISSIMER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MANOR AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-2601
Mailing Address - Country:US
Mailing Address - Phone:302-373-2394
Mailing Address - Fax:
Practice Address - Street 1:101 MANOR AVE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2601
Practice Address - Country:US
Practice Address - Phone:302-373-2394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006907133V00000X
PAPT020673225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered