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General NPI Number Information
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NPI Number | 1003113986
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Entity Type | Individual
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Provider Name | MR. FRED J. POPESKI
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Gender | Male
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Dates
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Enumeration Date | 02/11/2011
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Last Update Date | 02/11/2011
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Provider Practice Location Address
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Address Line | 4508 ZUCK RD
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City | ERIE
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State | PA
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Zip | 16506-4523
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Country | US
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Telephone | 814-323-2104
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Fax |
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Provider Business Mailing Address
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Address Line | 5291 W 52ND ST
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City | FAIRVIEW
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State | PA
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Zip | 16415-2334
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Country | US
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Telephone | 814-836-9955
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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