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General NPI Number Information
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NPI Number | 1033322466
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Entity Type | Organization
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Legal Business Name | FAMILY PRACTICE CENTER, PC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 270 SUSQUEHANNA VALLEY MALL DR STE 200
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City | SELINSGROVE
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State | PA
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Zip | 17870-9121
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Country | US
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Telephone | 570-884-7920
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Fax | 570-884-7928
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Provider Business Mailing Address
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Address Line | 7 DOCK HILL RD
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City | MIDDLEBURG
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State | PA
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Zip | 17842-8910
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Country | US
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Telephone | 570-837-2123
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Fax | 570-837-2185
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Authorized Official
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Title or Position | LABORATORY DIRECTOR
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Name | CHRIS J DARRUP
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Credential | DO
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Telephone | 570-837-5889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 020650
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License Number State | PA
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