Provider Demographics
NPI:1831229301
Name:HARTZELL, ROBERT (ATC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:HARTZELL
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:BIRDSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19508-2139
Mailing Address - Country:US
Mailing Address - Phone:610-621-2334
Mailing Address - Fax:
Practice Address - Street 1:501 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:BIRDSBORO
Practice Address - State:PA
Practice Address - Zip Code:19508-2406
Practice Address - Country:US
Practice Address - Phone:484-256-3883
Practice Address - Fax:610-582-5405
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001916A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer