| Shellby Custer Lsw, P.c. | |
|
1360 Eisenhower Blvd Ste 402 Johnstown PA 15904-3338 | |
| (814) 242-1125 | |
| Not Available |
| Full Name | Shellby Custer Lsw, P.c. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1360 Eisenhower Blvd, Johnstown, Pennsylvania |
| Authorized Official Name and Position | Shellby Custer (DIRECTOR) |
| Authorized Official Contact | 8142421125 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shellby Custer Lsw, P.c. 1360 Eisenhower Blvd Ste 402 Johnstown PA 15904-3338 Ph: (814) 242-1125 | Shellby Custer Lsw, P.c. 1360 Eisenhower Blvd Ste 402 Johnstown PA 15904-3338 Ph: (814) 242-1125 |
| NPI Number | 1528325792 |
|---|---|
| Provider Enumeration Date | 04/12/2012 |
| Last Update Date | 04/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528325792 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | SW125419 (Pennsylvania) | Primary |
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