Provider Demographics
NPI:1700810835
Name:STANG, WILLIAM ALLEN JR (ATC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ALLEN
Last Name:STANG
Suffix:JR
Gender:M
Credentials:ATC
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Mailing Address - Street 1:207 LILLIBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PECKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18452
Mailing Address - Country:US
Mailing Address - Phone:570-430-9389
Mailing Address - Fax:570-457-7205
Practice Address - Street 1:501 SOUTH MAIN ST
Practice Address - Street 2:PHYSICAL THERAPY ASSOCIATES NEPA
Practice Address - City:OLD FORGE
Practice Address - State:PA
Practice Address - Zip Code:18518
Practice Address - Country:US
Practice Address - Phone:570-457-4099
Practice Address - Fax:570-457-7205
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
07970269OtherCERTIFICATION