Provider Demographics
NPI:1831375989
Name:FIDLER, ERIN LEIGH (MED, ATC, CSCS)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LEIGH
Last Name:FIDLER
Suffix:
Gender:F
Credentials:MED, ATC, CSCS
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:LEIGH
Other - Last Name:LOBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, ATC, CSCS
Mailing Address - Street 1:132 JUNIPER CT
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-2984
Mailing Address - Country:US
Mailing Address - Phone:610-306-8839
Mailing Address - Fax:
Practice Address - Street 1:9601 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-2643
Practice Address - Country:US
Practice Address - Phone:215-248-7191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0034142255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer