Individual
KYRA ROOF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
15 S 9TH ST, LEBANON, PA 17042-5104
(717) 273-5992
(717) 273-5995
Mailing address
410 N PRINCE ST, LANCASTER, PA 17603-3010
(717) 560-7917
(717) 560-6452
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN298202
PA
Other
Enumeration date
01/22/2018
Last updated
07/29/2019
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