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Organization
LOG SURGERY CENTER, LLC
Active
Organization
LOG SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCILLE FORMEISTER (DIRECTOR, BUSINESS SYSTEMS)
(860) 667-9542
Entity
Organization
Contact information
Practice address
413 GRANITE RUN DR, LANCASTER, PA 17601-6809
(860) 667-9542
Mailing address
413 GRANITE RUN DR, LANCASTER, PA 17601-6809
(860) 667-9542
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
02/24/2021
Last updated
06/15/2021
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