Individual
MRS. CHARITY RAQUEL POLYDORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN
Contact information
Practice address
1700 S LINCOLN AVE, LEBANON, PA 17042-7529
(717) 272-6621
(717) 228-6120
Mailing address
1700 S LINCOLN AVE, LEBANON, PA 17042-7529
(717) 272-6621
(717) 228-6120
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1109090
KY
Other
Enumeration date
04/16/2018
Last updated
04/16/2018
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