White Deer Run

NPI 1053617118 - Clinic/Center - 261Q00000X

NPI Details
NPI 1053617118
Enumeration Date 02/07/2011
Last Updated 08/30/2015
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name TOM TOM
Position REGIONAL VICE PRESIDENT
Phone (570) 322-4836
Fax (570) 322-4769
Practice Location
520 W 4TH ST
WILLIAMSPORT PA, 17701-6038, US
Phone (570) 322-4836
Fax (570) 322-4769
Business Location
520 W 4TH ST
WILLIAMSPORT PA, 17701-6038, US
Phone (570) 322-4836
Fax
Toxanomy
Taxonomy Code 261Q00000X
License State Pennsylvania
License Number 417040
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According to our database, White Deer Run NPI is 1053617118, taxonomy code is 261Q00000X and license number is 417040, license state is located at Pennsylvania. White Deer Run physically located at 520 W 4th St, Williamsport PA, 17701-6038. NPI Number 1033115704 has the healthcare provider type.

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1053617118 NPI number is provided on an as is basis without warranty of any kind. 1053617118 is maintained by the National Plan & Provider Enumeration System. The contents of White Deer Run are for informational purposes only.