Larry Lightfoot

NPI 1770960502 - Behavioral Analyst - 103K00000X

NPI Details
NPI 1770960502
Gender Male
Enumeration Date 04/30/2015
Last Updated 04/30/2015
Entity Type Individual
Active Over 1 year ago
Practice Location
221 MAHANTONGO STREET
POTTSVILLE PA, 17901, US
Phone (570) 622-6417
Fax
Business Location
221 MAHANTONGO ST
POTTSVILLE PA, 17901-3010, US
Phone
Fax
Toxanomy
Taxonomy Code 103K00000X
License State Pennsylvania
License Number BH000103
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According to our database, Larry Lightfoot NPI is 1770960502, taxonomy code is 103K00000X and license number is BH000103, license state is located at Pennsylvania. Larry Lightfoot physically located at 221 Mahantongo Street, Pottsville PA, 17901. NPI Number Larry Lightfoot has the Individual type.

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1770960502 NPI number is provided on an as is basis without warranty of any kind. 1770960502 is maintained by the National Plan & Provider Enumeration System. The contents of Larry Lightfoot are for informational purposes only.