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General NPI Number Information
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NPI Number | 1295508240
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Entity Type | Individual
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Provider Name | BRIANNA LOEW
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Gender | Female
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Dates
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Enumeration Date | 11/01/2023
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 623 WYOMING STREET
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City | TUSCARORA
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State | PA
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Zip | 19782
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Country | US
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Telephone | 570-778-7095
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Fax |
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Provider Business Mailing Address
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Address Line | 623 WYOMING STREET
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City | TUSCARORA
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State | PA
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Zip | 19782
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Country | US
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Telephone |
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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