Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Sep 18, 2019
License(s)
SP020609 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 801 OSTRUM ST | Bethlehem, PA 18015-1000 | 484-526-4999 |
| LOCATION | 770 STATE RD | Lehighton, PA 18235-2857 | 272-639-5060 |
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