Provider Demographics
NPI:1700659778
Name:RINEER, JOLYN AMBER
Entity Type:Individual
Prefix:
First Name:JOLYN
Middle Name:AMBER
Last Name:RINEER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 WIGEON WAY
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-8850
Mailing Address - Country:US
Mailing Address - Phone:717-413-1365
Mailing Address - Fax:
Practice Address - Street 1:141 HEISEY AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:PA
Practice Address - Zip Code:17022-8107
Practice Address - Country:US
Practice Address - Phone:717-367-1831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP007258224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant