Organization
PRIVATE PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MCCONNELL (RN)
(724) 322-7745
Entity
Organization
Contact information
Practice address
202 FISHPOT RD, FREDERICKTOWN, PA 15333-2203
(724) 322-7745
Mailing address
202 FISHPOT RD, FREDERICKTOWN, PA 15333-2203
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
RN320432L
PA
Other
Enumeration date
07/11/2014
Last updated
07/11/2014
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