Organization
NULTON DIAGNOSTIC & TREATMENT CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY J NULTON (OWNER)
(814) 262-0025
Entity
Organization
Contact information
Practice address
214 COLLEGE PARK PLZ, JOHNSTOWN, PA 15904-2833
(814) 262-0025
(814) 266-8745
Mailing address
214 COLLEGE PARK PLZ, JOHNSTOWN, PA 15904-2833
(814) 262-0025
(814) 266-8745
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2084P0005X
Neurodevelopmental Disabilities Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
117055
PA
251S00000X
Community/Behavioral Health Agency
314080
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007324900011
—
PA
Enumeration date
03/24/2006
Last updated
06/09/2026
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