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Organization
WILLIAMSPORT PHYSICAL MEDICINE, INC.
Active
Organization
WILLIAMSPORT PHYSICAL MEDICINE, INC.
Active
Parent organization
WILLIAMSPORT PHYSICAL MEDICINE, INC.
Other names
Neuropathy Center of NEPA
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILLIAMSPORT PHYSICAL MEDICINE, INC.
Authorized official
MARK HAMPTON D.C. (PRESIDENT)
(570) 322-5500
Entity
Organization
Contact information
Practice address
1101 E 3RD ST, WILLIAMSPORT, PA 17701-5411
(570) 322-5500
(570) 322-8100
Mailing address
1101 E 3RD ST, WILLIAMSPORT, PA 17701-5411
(570) 322-5500
(570) 322-8100
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2125269
BLUE CROSS BLUE SHIELD
PA
Enumeration date
12/08/2011
Last updated
12/08/2011
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