Provider Demographics
NPI:1831853589
Name:ANDERSON, JOSHUA CLARK
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:CLARK
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5060 PINE GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9403
Mailing Address - Country:US
Mailing Address - Phone:484-602-7266
Mailing Address - Fax:
Practice Address - Street 1:100 W PATTERSON ST
Practice Address - Street 2:
Practice Address - City:LANSFORD
Practice Address - State:PA
Practice Address - Zip Code:18232-1304
Practice Address - Country:US
Practice Address - Phone:570-645-8197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist