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General NPI Number Information
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NPI Number | 1912788324
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Entity Type | Organization
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Legal Business Name | MARY TURNER SKIN CARE AND CLEARSKIN ACNE CLINIC LLC
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Dates
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Enumeration Date | 10/11/2023
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 2539 WILMINGTON RD STE C
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City | NEW CASTLE
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State | PA
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Zip | 16105-1636
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Country | US
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Telephone | 724-657-5156
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Fax | 724-657-1647
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Provider Business Mailing Address
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Address Line | 315 E LINCOLN AVE
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City | NEW CASTLE
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State | PA
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Zip | 16101-2529
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Country | US
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Telephone | 724-674-2161
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Fax |
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Authorized Official
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Title or Position | OWNER/LASER TECHNICIAN/ESTHETICIAN
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Name | MARY L TURNER
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Credential | LC CLT
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Telephone | 724-657-5156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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