Organization
PENNSYLVANIA WESTERN UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH RAE KUNDICK (FISCAL TECHNICIAN)
(814) 297-8220
Entity
Organization
Contact information
Practice address
1008 S 5TH AVE, CLARION, PA 16214-8676
(814) 297-8220
(814) 297-8381
Mailing address
1008 S 5TH AVE, CLARION, PA 16214-8676
(814) 297-8220
(814) 297-8381
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
207RI0200X
Infectious Disease Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
03/18/2025
Last updated
03/18/2025
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