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104 Front Street Van # 1 Mount Morris PA 15349-0495 | |
(888) 454-5064 | |
(724) 324-9005 |
Full Name | |
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Speciality | Clinic/center |
Location | 104 Front Street, Mount Morris, Pennsylvania |
Authorized Official Name and Position | Robert Mtjoy (CEO) |
Authorized Official Contact | 7249433308 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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104 Front Street Van #1 Mount Morris PA 15349-0495 Ph: (888) 454-5064 | 104 Front Street Van # 1 Mount Morris PA 15349-0495 Ph: (888) 454-5064 |
NPI Number | 1134440159 |
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Provider Enumeration Date | 06/14/2010 |
Last Update Date | 06/14/2010 |
Identifier | Type | State | Issuer |
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1134440159 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |