Full Name | |
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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 |
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3421 Concord Rd York PA 17402-9001 Ph: (717) 851-1405 | 136 Lake St Ephrata PA 17522-2415 Ph: (717) 721-7718 |
NPI Number | 1588114094 |
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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 |