Healthcare Provider Details

I. General information

NPI: 1801883970
Provider Name (Legal Business Name): LANCASTER NEUROSCIENCE & SPINE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 10/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1671 CROOKED OAK DR THE CTR FOR SPINE CARE AT LANCASTER NEUROSCIENCE & SPIN
LANCASTER PA
17601-4207
US

IV. Provider business mailing address

1671 CROOKED OAK DR
LANCASTER PA
17601-4269
US

V. Phone/Fax

Practice location:
  • Phone: 717-569-5331
  • Fax: 717-569-4210
Mailing address:
  • Phone: 717-569-5331
  • Fax: 717-569-4210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number15481501
License Number StatePA

VIII. Authorized Official

Name: MR. MARTIN J LOWTHER
Title or Position: ADMINISTRATOR
Credential:
Phone: 717-569-5331