Provider Demographics
NPI:1912236274
Name:MIEL, DON VAN EARL (PT)
Entity Type:Individual
Prefix:
First Name:DON VAN EARL
Middle Name:
Last Name:MIEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:DON VAN EARL
Other - Middle Name:AGAR
Other - Last Name:MIEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:3855 BLAIR MILL RD
Mailing Address - Street 2:APT 213C
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-2998
Mailing Address - Country:US
Mailing Address - Phone:808-722-1441
Mailing Address - Fax:
Practice Address - Street 1:3485 DAVISVILLE RD
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040-4220
Practice Address - Country:US
Practice Address - Phone:808-722-1441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-16
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-3155225100000X
PAPT022541225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist