Provider Demographics
NPI:1972027712
Name:ANCHETA, DAVE ALLAN JAY HO (PT)
Entity type:Individual
Prefix:
First Name:DAVE ALLAN JAY
Middle Name:HO
Last Name:ANCHETA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 282
Mailing Address - Street 2:
Mailing Address - City:KYLERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:16847-0282
Mailing Address - Country:US
Mailing Address - Phone:412-551-4595
Mailing Address - Fax:
Practice Address - Street 1:502 E HOWARD ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-2128
Practice Address - Country:US
Practice Address - Phone:814-355-6884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019633225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist