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General NPI Number Information
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NPI Number | 1003070871
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Entity Type | Organization
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Legal Business Name | ERIE SLEEP & WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 03/31/2010
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Provider Practice Location Address
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Address Line | 240 W 11TH ST SUITE 301
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City | ERIE
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State | PA
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Zip | 16501-1758
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Country | US
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Telephone | 814-455-1500
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Fax | 814-455-3109
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Provider Business Mailing Address
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Address Line | 240 W 11TH ST SUITE 301
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City | ERIE
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State | PA
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Zip | 16501-1758
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Country | US
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Telephone | 814-455-1500
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Fax | 814-455-3109
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Authorized Official
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Title or Position | CEO
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Name | MR. THOMAS C MCWILLIAMS
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Credential |
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Telephone | 814-455-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YS0012X
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Taxonomy Name | Sleep Medicine (Otolaryngology) Physician
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License Number |
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License Number State |
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