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General NPI Number Information
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NPI Number | 1174587570
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Entity Type | Organization
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Legal Business Name | SAMUEL E SCHRACK, D.O., P.C.
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 11/24/2009
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Provider Practice Location Address
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Address Line | 520 W 4TH ST SUITE 1A
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-6038
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Country | US
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Telephone | 570-327-9110
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Fax | 570-327-1181
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Provider Business Mailing Address
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Address Line | 520 W 4TH ST SUITE 1A
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-6038
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Country | US
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Telephone | 570-327-9110
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Fax | 570-327-1181
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LISA R MILLER
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Credential |
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Telephone | 570-327-9110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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