Provider Demographics
NPI:1316080054
Name:SCHWILLE, GERALD BOWEN (ATC)
Entity type:Individual
Prefix:MR
First Name:GERALD
Middle Name:BOWEN
Last Name:SCHWILLE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:227 AUTUMN WOODS CT
Mailing Address - Street 2:
Mailing Address - City:DILLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17019-1398
Mailing Address - Country:US
Mailing Address - Phone:717-599-8276
Mailing Address - Fax:717-502-1981
Practice Address - Street 1:653 S BALTIMORE ST
Practice Address - Street 2:NORTHERN YORK HIGH SCHOOL
Practice Address - City:DILLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17019-9690
Practice Address - Country:US
Practice Address - Phone:717-432-8691
Practice Address - Fax:717-502-1981
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART000324A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer