Most Relevant Information
Provider Data
| NPI Number: | 1003512401 |
| Provider Name: | GERALD DIETRICH |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT030043 |
Most Important Dates
| Enumeration Date: | 02/07/2023 |
| Last Updated: | 02/07/2023 |
Provider Practice Location
4112 SPRINGHILL RD
PORTAGE
PA
159467402
Practice Location Phone/Fax
| Phone: | 8145068212 |
| Fax: | 8145068213 |
Provider Mailing Location
PO BOX 870
HUNTINGDON
PA
166520870
Provider Mailing Phone/Fax
| Phone: | 8145068212 |
| Fax: | 8145068213 |