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General NPI Number Information
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NPI Number | 1750410346
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Entity Type | Organization
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Legal Business Name | VALLEY AMBULATORY HEALTH CENTER, P.C.
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 02/09/2010
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Provider Practice Location Address
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Address Line | 238 INDIANA STREET
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City | SEWARD
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State | PA
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Zip | 15954
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Country | US
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Telephone | 814-446-5695
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Fax | 814-446-4209
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Provider Business Mailing Address
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Address Line | PO BOX 486
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City | SEWARD
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State | PA
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Zip | 15954-0486
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Country | US
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Telephone | 814-446-5695
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Fax |
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Authorized Official
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Title or Position | PHYSICAN, OWNER OF COMPANY
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Name | DENNIS LEE ECKELS
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Credential | D.O., F.A.A.F.P.
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Telephone | 814-446-5695
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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 | OS-009298-L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS-003436-L
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License Number State | PA
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