| |
4315 Londonderry Rd, Harrisburg, PA 17109-5318 | |
(717) 909-0290 | |
(717) 909-0292 |
Full Name | |
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Type | Facility |
Speciality | Family Medicine |
Location | 4315 Londonderry Rd, Harrisburg, Pennsylvania |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235491416 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 2353, Harrisburg, PA 17105-2353 Ph: (717) 230-3717 | 4315 Londonderry Rd, Harrisburg, PA 17109-5318 Ph: (717) 909-0290 |