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General NPI Number Information
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NPI Number | 1790160901
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Entity Type | Organization
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Legal Business Name | LANCASTER MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 07/29/2015
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | 90 GOOD DR STE 101
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City | LANCASTER
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State | PA
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Zip | 17603-4360
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Country | US
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Telephone | 717-299-3020
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Fax |
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Provider Business Mailing Address
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Address Line | 90 GOOD DR STE 101
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City | LANCASTER
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State | PA
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Zip | 17603-4360
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Country | US
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Telephone | 717-299-3020
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | DENNIS HERTZ
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Credential |
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Telephone | 717-291-8078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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