Provider Demographics
NPI:1386998342
Name:WARNER, CRAIG REED (PTA)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:REED
Last Name:WARNER
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:MR
Other - First Name:CRAIG
Other - Middle Name:REED
Other - Last Name:WARNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:129 CHAIN SAW RD
Mailing Address - Street 2:
Mailing Address - City:DILLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17019-9473
Mailing Address - Country:US
Mailing Address - Phone:717-432-4370
Mailing Address - Fax:
Practice Address - Street 1:700 WALNUT BOTTOM RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3631
Practice Address - Country:US
Practice Address - Phone:717-960-7720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE1001724225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant