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Individual

CHERESSA LISETTE MIX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1205 RIVER AVE, 2ND FLOOR, WILLIAMSPORT, PA 17701-3724
(570) 326-4118
(570) 326-5533
Mailing address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA051507
PA
363A00000X
Physician Assistant
Primary
OA002107
PA

Other

Enumeration date
07/18/2006
Last updated
01/18/2016
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