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757 Johnsonburg Rd Suite 110 Saint Marys PA 15857-3488 | |
(814) 788-8580 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 757 Johnsonburg Rd, Saint Marys, Pennsylvania |
Authorized Official Name and Position | Brian Kline (CFO) |
Authorized Official Contact | 8143756377 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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100 Hospital Ave Du Bois PA 15801-1440 Ph: () - | 757 Johnsonburg Rd Suite 110 Saint Marys PA 15857-3488 Ph: (814) 788-8580 |
NPI Number | 1275918997 |
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Provider Enumeration Date | 07/23/2015 |
Last Update Date | 07/23/2015 |
Identifier | Type | State | Issuer |
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1275918997 | NPI | - | NPPES |
100774088 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |