Organization
SUSQUEHANNA PHYSICIAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA DAVIS (VP/COO)
(570) 326-8544
Entity
Organization
Contact information
Practice address
1201 GRAMPIAN BLVD STE 2F, WILLIAMSPORT, PA 17701-1965
(570) 321-2020
(570) 320-7599
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
12/04/2020
Last updated
12/04/2020
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