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General NPI Number Information
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NPI Number | 1710218847
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Entity Type | Individual
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Provider Name | JAMES CHRISTOPHER ZWANCH D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/29/2010
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Last Update Date | 06/09/2014
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Provider Practice Location Address
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Address Line | 590 W RIDGE RD SUITE D
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City | WYTHEVILLE
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State | VA
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Zip | 24382-1094
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Country | US
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Telephone | 570-498-2799
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Fax |
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Provider Business Mailing Address
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Address Line | 2604 WALNUT RIDGE EST
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City | POTTSTOWN
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State | PA
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Zip | 19464-3092
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Country | US
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Telephone | 570-498-2799
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | OT 013225
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0102203791
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License Number State | VA
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