Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Nov 20, 2014
License(s)
MD461253 (PA), MD461253 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 5 S WASHINGTON AVE | Jermyn, PA 18433-1121 | 570-230-0019 |
| MAILING | 5 S WASHINGTON AVE | Jermyn, PA 18433-1121 | 570-230-0019 |
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