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Individual

MR. PETER KEITH TOWNSEND JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
ROUTE 307, LAKE WINOLA, PA 18625-0489
(570) 378-3047
(570) 378-3418
Mailing address
PO BOX 489, LAKE WINOLA, PA 18625-0489
(570) 378-3047
(570) 378-3418

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA-001763-L
PA

Other

Enumeration date
08/28/2013
Last updated
08/28/2013
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