Individual
REBECCA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
479 WYOMING ST, HANOVER TWP, PA 18706-3342
(570) 899-9575
Mailing address
479 WYOMING ST, HANOVER TWP, PA 18706-3342
(570) 899-9575
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN258439L
PA
Other
Enumeration date
05/02/2013
Last updated
05/02/2013
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