# CHARLES W. STOTLER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912141748
- **Authorized official:** MRS. KAREN M SYBERT CMA (BILLING COORDINATOR)
- **Authorized official phone:** (814) 736-9628

## Contact information

- **Practice address:** 711 CALDWELL AVE, PORTAGE, PA 15946-1557
- **Practice address phone:** (814) 736-9628
- **Practice address fax:** (814) 736-3797
- **Mailing address:** 711 CALDWELL AVE, PORTAGE, PA 15946-1557
- **Mailing address phone:** (814) 736-9628
- **Mailing address fax:** (814) 736-3797

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 017069E | PA | Yes |

## Other

- **Enumeration date:** 04/23/2009
- **Last updated:** 04/23/2009