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General NPI Number Information
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NPI Number | 1811414162
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Entity Type | Organization
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Legal Business Name | SPIRIT PHYSCIAN SERVICES, INC
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 08/28/2017
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Provider Practice Location Address
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Address Line | 310 E PENN DR
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City | ENOLA
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State | PA
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Zip | 17025-2175
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Country | US
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Telephone | 717-857-2490
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Fax | 717-857-2491
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Provider Business Mailing Address
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Address Line | 100 N ACADEMY AVE
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City | DANVILLE
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State | PA
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Zip | 17822-4903
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Country | US
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Telephone | 570-271-6144
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CINDY MULL
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Credential |
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Telephone | 570-271-6144
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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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