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General NPI Number Information
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NPI Number | 1871921908
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Entity Type | Organization
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Legal Business Name | GLADE RUN MEDICAL ASSOCIATES INC
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 116 MAIN ST
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City | LEECHBURG
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State | PA
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Zip | 15656-1333
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Country | US
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Telephone | 724-845-8479
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Fax | 724-845-7764
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Provider Business Mailing Address
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Address Line | 116 MAIN ST
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City | LEECHBURG
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State | PA
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Zip | 15656-1333
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Country | US
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Telephone | 724-845-8479
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Fax | 724-845-7764
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Authorized Official
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Title or Position | CFO & VP FINANCE
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Name | MR. PATRICK BURNS
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Credential |
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Telephone | 724-543-8618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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