Individual
MRS. LAUREL FOXWORTH DODGSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RPA-C
Contact information
Practice address
25 CHURCH ST, WILKES BARRE, PA 18765-0999
(570) 808-8740
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA054439
PA
363AS0400X
Surgical Physician Assistant
012690-1
NY
Other
Enumeration date
11/26/2008
Last updated
12/30/2020
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