Provider Demographics
NPI:1871124032
Name:FYOCK, PATRICIA MAUREEN (PT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MAUREEN
Last Name:FYOCK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1398 OLD FORBES RD
Mailing Address - Street 2:
Mailing Address - City:STOYSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15563-8765
Mailing Address - Country:US
Mailing Address - Phone:814-442-0258
Mailing Address - Fax:
Practice Address - Street 1:1075 OLD HARRISBURG RD
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-3135
Practice Address - Country:US
Practice Address - Phone:717-334-6204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-006455-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist