Individual
JUDY ANN STOLLATIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8461 GRUBB RD, MC KEAN, PA 16426-1234
(814) 476-1317
Mailing address
8461 GRUBB RD, MC KEAN, PA 16426-1234
(814) 476-1317
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN059025L
PA
Other
Enumeration date
10/12/2012
Last updated
10/12/2012
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