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Organization
PEQUEA VALLEY COMMUNITY MEDICINE
Active
Organization
PEQUEA VALLEY COMMUNITY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA R LACORTE RN (ADMINISTRATOR)
(717) 442-9505
Entity
Organization
Contact information
Practice address
836 HOUSTON RUN DR, SUITE 201, GAP, PA 17527-9496
(717) 442-9505
(717) 442-9531
Mailing address
836 HOUSTON RUN DR, SUITE 201, GAP, PA 17527-9496
(717) 442-9505
(717) 442-9531
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
01/10/2013
Last updated
01/10/2013
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