Provider Demographics
NPI:1295061950
Name:PLUNKETT, JOAN A (PTA)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:A
Last Name:PLUNKETT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:JOAN
Other - Middle Name:A
Other - Last Name:MCGUIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:220 NEWRY ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-1626
Mailing Address - Country:US
Mailing Address - Phone:814-693-4016
Mailing Address - Fax:
Practice Address - Street 1:220 NEWRY ST
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-1626
Practice Address - Country:US
Practice Address - Phone:814-693-4016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE1000108225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant