Organization
H.B.P.A. MEDICAL CLINIC
Active
Other names
Jeanette Johnston H.B.P.A Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD MOSTOLLER (EXECUTIVE DIRECTOR)
(717) 469-2970
Entity
Organization
Contact information
Practice address
1111 FIRE HOUSE RD, GRANTVILLE, PA 17028
(717) 469-2970
(717) 469-7714
Mailing address
1111 FIREHOUSE RD., GRANTVILLE, PA 17028
(717) 469-2970
(717) 469-7714
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN163-298L
PA
207Q00000X
Family Medicine Physician
Primary
OS-006156-L
PA
Other
Enumeration date
05/14/2012
Last updated
05/14/2012
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