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Organization
MILLCREEK MANOR
Active
Organization
MILLCREEK MANOR
Active
Parent organization
MILLCREEK MANOR
Other names
Clinical Practice of LECOM Institute for Successful Living
Organization subpart
Yes
Provider details
NPI number
Legal business name
MILLCREEK MANOR
Authorized official
OLIVIA J TOPEL (CFO)
(814) 881-5234
Entity
Organization
Contact information
Practice address
5401 PEACH ST STE 3400, ERIE, PA 16509-2601
(814) 868-2200
Mailing address
5535 PEACH ST, ERIE, PA 16509-2603
(814) 881-5234
(814) 871-4545
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Enumeration date
07/12/2023
Last updated
10/04/2023
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