| Wellspan Family Medicine - Lake Street | |
|
136 Lake St Ephrata PA 17522-2415 | |
| (717) 721-7718 | |
| (717) 721-7726 |
| Full Name | Wellspan Family Medicine - Lake Street |
|---|---|
| Speciality | Family Medicine |
| Location | 136 Lake St, Ephrata, Pennsylvania |
| Authorized Official Name and Position | Christina Moon (SUPERVISOR-VERIFICATION SERVICES) |
| Authorized Official Contact | 7178511405 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspan Family Medicine - Lake Street 3421 Concord Rd York PA 17402-9001 Ph: (717) 851-1405 | Wellspan Family Medicine - Lake Street 136 Lake St Ephrata PA 17522-2415 Ph: (717) 721-7718 |
| NPI Number | 1588114094 |
|---|---|
| Provider Enumeration Date | 10/07/2016 |
| Last Update Date | 10/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588114094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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