Provider Demographics
NPI:1982786398
Name:THEIS, JOSEPH JAMES (ATC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:JAMES
Last Name:THEIS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2327 MCCLEARY DR
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-7940
Mailing Address - Country:US
Mailing Address - Phone:717-477-1749
Mailing Address - Fax:
Practice Address - Street 1:1871 OLD MAIN DR
Practice Address - Street 2:ATHLETICS DEPARTMENT
Practice Address - City:SHIPPENSBURG
Practice Address - State:PA
Practice Address - Zip Code:17257-2200
Practice Address - Country:US
Practice Address - Phone:717-477-1749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0031822255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer