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Organization
PANTHER VALLEY FAMILY PRACTICE PC
Active
Organization
PANTHER VALLEY FAMILY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH FRANCIS MUSSOLINE D.O. (PRESIDENT)
(570) 645-3133
Entity
Organization
Contact information
Practice address
134 W RIDGE ST, LANSFORD, PA 18232-1310
(570) 645-3133
Mailing address
134 W RIDGE ST, LANSFORD, PA 18232-1310
(570) 645-3133
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS005238L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017900740001
—
PA
Enumeration date
08/18/2006
Last updated
08/22/2020
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