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Organization
OLD FORGE WELLNESS LLC
Active
Organization
OLD FORGE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI ANN SLOCUM PHARMD (CEO)
(570) 774-4171
Entity
Organization
Contact information
Practice address
821 S MAIN ST STE 1, OLD FORGE, PA 18518-1497
(570) 774-4171
(570) 457-3220
Mailing address
821 S MAIN ST STE 1, OLD FORGE, PA 18518-1497
(570) 774-4171
(570) 457-3220
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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