Individual
JESSE GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
86 RUN VALLEY RD, CONESTOGA, PA 17516-9734
(717) 723-0147
Mailing address
86 RUN VALLEY RD, CONESTOGA, PA 17516-9734
(717) 723-0147
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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