Provider Demographics
NPI:1912329285
Name:STILL-GLOSSER, CORAL MARIE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:CORAL
Middle Name:MARIE
Last Name:STILL-GLOSSER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2899 LOMAN AVE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17408-9478
Mailing Address - Country:US
Mailing Address - Phone:717-577-4774
Mailing Address - Fax:
Practice Address - Street 1:200 FARM LN
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-4974
Practice Address - Country:US
Practice Address - Phone:717-577-4774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-06
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG008146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist