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General NPI Number Information
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NPI Number | 1811951395
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Entity Type | Individual
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Provider Name | MARY ELIZABETH REESE PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 07/15/2013
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Provider Practice Location Address
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Address Line | 550 W COLLEGE AVE
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City | PLEASANT GAP
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State | PA
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Zip | 16823-7401
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Country | US
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Telephone | 814-359-5620
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Fax | 814-359-5629
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Provider Business Mailing Address
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Address Line | PO BOX 251
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City | BOALSBURG
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State | PA
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Zip | 16827-0251
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Country | US
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Telephone | 814-235-3051
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Fax | 814-359-5629
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA000413L
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License Number State | PA
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