Provider Demographics
NPI:1912907213
Name:LONTZ, ROBERT NEVIN (PT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:NEVIN
Last Name:LONTZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5300 DERRY ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3576
Mailing Address - Country:US
Mailing Address - Phone:717-839-2110
Mailing Address - Fax:717-565-1934
Practice Address - Street 1:1805 LOUCKS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-7902
Practice Address - Country:US
Practice Address - Phone:717-764-0144
Practice Address - Fax:717-754-0554
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT010109L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
445797OtherCOVENTRY HEALTH AMERICA
1404706OtherHIGHMARK BLUE SHIELD
PA1011851810002Medicaid
50063225OtherBLUE CROSS KEYSTONE
PA1011851810002Medicaid