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Organization
WELLSPAN MEDICAL GROUP
Active
Organization
WELLSPAN MEDICAL GROUP
Active
Other names
WellSpan Family Medicine - Granite Run
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA MOON (SUPERVISOR-VERIFICATION SERVICES)
(717) 851-1405
Entity
Organization
Contact information
Practice address
264 GRANITE RUN DR, LANCASTER, PA 17601-6804
(717) 721-8205
(717) 721-8251
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-1405
(717) 851-6969
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/07/2016
Last updated
10/07/2016
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