Provider Demographics
NPI:1548297583
Name:PRIETO, WILLIAM L (MED, ATC, LAT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:L
Last Name:PRIETO
Suffix:
Gender:M
Credentials:MED, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 MEADOWCREEK DR S
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17202-8267
Mailing Address - Country:US
Mailing Address - Phone:717-261-7066
Mailing Address - Fax:
Practice Address - Street 1:65 MEADOWCREEK DR S
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-8267
Practice Address - Country:US
Practice Address - Phone:717-261-7066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001356A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE129402404OtherNATA BOC