Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Apr 7, 2025
License(s)
MA066788 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1001 E 2ND ST | Coudersport, PA 16915-8161 | 814-274-5276 |
| LOCATION | 1001 E 2ND ST | Coudersport, PA 16915-8161 | 814-274-5276 |
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