Provider Demographics
NPI:1295757367
Name:LEHR, MICHAEL EDWARD (MPT, CSCS, OCS)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:EDWARD
Last Name:LEHR
Suffix:
Gender:M
Credentials:MPT, CSCS, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 COLONIAL CIR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17046-1975
Mailing Address - Country:US
Mailing Address - Phone:717-279-6889
Mailing Address - Fax:
Practice Address - Street 1:550 N 12TH ST
Practice Address - Street 2:SUITE 120
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1242
Practice Address - Country:US
Practice Address - Phone:717-737-9818
Practice Address - Fax:717-737-2815
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016313225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01963372Medicaid