Individual
BRENDA L STANISLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1700 S LINCOLN AVE, LEBANON, PA 17042-7529
(610) 208-4717
Mailing address
1700 S LINCOLN AVE, LEBANON, PA 17042-7529
(610) 208-4717
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA0001856-L
PA
Other
Enumeration date
09/29/2006
Last updated
07/08/2007
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