Individual
JESSE TODD COLABINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5176 CREEK RD, BEAVERTOWN, PA 17813-9268
(570) 898-6349
Mailing address
5176 CREEK RD, BEAVERTOWN, PA 17813-9268
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA053457
PA
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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