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Organization

SLATE BELT FAMILY PRACTICE PC

Active
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Organization

SLATE BELT FAMILY PRACTICE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WAYNE J BROTZMAN JR. D.O. (PHYSICIAN)
(610) 863-3019
Entity
Organization

Contact information

Practice address
826 S BROADWAY, WIND GAP, PA 18091-1628
(610) 863-3019
(610) 863-6732
Mailing address
826 S BROADWAY, WIND GAP, PA 18091-1628
(610) 863-3019
(610) 863-6732

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OS-006844L
PA
207Q00000X
Family Medicine Physician
Primary
OS-007427L
PA

Other

Enumeration date
01/24/2006
Last updated
04/24/2008
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