Provider Demographics
NPI:1487086443
Name:EISENBACH, ERIKA D (PT, DPT)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:D
Last Name:EISENBACH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-1640
Mailing Address - Country:US
Mailing Address - Phone:570-282-9382
Mailing Address - Fax:570-227-1891
Practice Address - Street 1:27 MAIN ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-1640
Practice Address - Country:US
Practice Address - Phone:570-282-9382
Practice Address - Fax:570-227-1891
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022830225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist