Organization
PENNSYLVANIA PHYSICIAN SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM H LARSEN (DIRECTOR OF CREDENTIALING)
(770) 874-5400
Entity
Organization
Contact information
Practice address
700 QUINCY AVE, SCRANTON, PA 18510-1724
(570) 770-5000
Mailing address
PO BOX 21113, BELFAST, ME 04915-4108
(770) 874-5400
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
08/22/2014
Last updated
02/05/2020
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