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Organization

CLINICAL PRACTICE OF LECOM INSTITUTE FOR SUCCESSFUL LIVING

Active
Parent organization
MILLCREEK MANOR
Other names
Rural Health Clinic of Wattsburg
Organization subpart
Yes

Provider details

NPI number
Legal business name
MILLCREEK MANOR
Authorized official
JAMES Y LIN DO (PRESIDENT)
(814) 602-7783
Entity
Organization

Contact information

Practice address
9040 WATTSBURG RD, ERIE, PA 16509-6024
(814) 844-2858
Mailing address
5401 PEACH ST STE 3400, ERIE, PA 16509-2601
(814) 868-2200

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
261QR1300X
Rural Health Clinic/Center
Primary

Other

Enumeration date
01/22/2024
Last updated
01/22/2024
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