Organization
BLAIR MEDICLA ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L. BRYAN (PROJECTS MGR.)
(814) 949-7621
Entity
Organization
Contact information
Practice address
1414 NINTH AVENUE, BLAIR MEDICAL ASSOCIATES, ALTOONA, PA 16602
(814) 946-1655
(814) 949-7616
Mailing address
1414 NINTH AVENUE, BLAIR MEDICAL ASSOCIATES, ALTOONA, PA 16602
(814) 946-1655
(814) 949-7616
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1014409
GATEWAY NEURO SPECIALITY
PA
Enumeration date
02/13/2007
Last updated
08/22/2020
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