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1 Mellon Way Latrobe PA 15650-1197 | |
(724) 539-3555 | |
(724) 539-1966 |
Full Name | |
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Speciality | Family Medicine |
Location | 1 Mellon Way, Latrobe, Pennsylvania |
Authorized Official Name and Position | Michael Busch (CHIEF OPERATING OFFICER) |
Authorized Official Contact | 7246891650 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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520 Jefferson Ave Suite 400 Jeannette PA 15644-2538 Ph: (724) 850-6933 | 1 Mellon Way Latrobe PA 15650-1197 Ph: (724) 539-3555 |
NPI Number | 1942755608 |
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Provider Enumeration Date | 08/23/2016 |
Last Update Date | 08/23/2016 |
Identifier | Type | State | Issuer |
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1942755608 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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