Basic Information
| Provider Information | |||||||||
| NPI: | 1891431631 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MITCHELTREE | ||||||||
| FirstName: | CARRIE | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 958 LOG RD | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174039462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176763325 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5690 ALLENTOWN BLVD | ||||||||
| Address2: | |||||||||
| City: | HARRISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 171124046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172168699 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2022 | ||||||||
| LastUpdateDate: | 05/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.