Individual
JOHN PONTICIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
553 1ST ST, PORT CARBON, PA 17965-1721
(570) 622-7785
(570) 622-1774
Mailing address
553 1ST ST, PORT CARBON, PA 17965-1721
(570) 622-7785
(570) 622-1774
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
PA060799
PA
171WV0202X
Vehicle Modifications Contractor
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Other
Enumeration date
01/27/2010
Last updated
01/27/2010
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