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Organization

KATHLEEN WIECZOREK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BARB BECKETT (BILLING SPECIALIST)
(330) 386-9300
Entity
Organization

Contact information

Practice address
5050 W RIDGE RD FL 2, ERIE, PA 16506-1216
(814) 836-3900
Mailing address
5050 W RIDGE RD FL 2, ERIE, PA 16506-1216

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
OS006523L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0016175890009
PA
Enumeration date
07/08/2008
Last updated
07/08/2008
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