Provider Demographics
NPI:1336272327
Name:ALTDOERFFER, URSZULA JOLANTA (PT)
Entity Type:Individual
Prefix:
First Name:URSZULA
Middle Name:JOLANTA
Last Name:ALTDOERFFER
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 1:224 S HOMESTEAD DR
Mailing Address - Street 2:
Mailing Address - City:LANDISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17538-1368
Mailing Address - Country:US
Mailing Address - Phone:717-892-1165
Mailing Address - Fax:717-892-1165
Practice Address - Street 1:336 S WEST END AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-5043
Practice Address - Country:US
Practice Address - Phone:717-393-0419
Practice Address - Fax:717-391-8129
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009003E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist