Individual
THOMAS RUNSCAVAGE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
816 NORTH ST, LUZERNE, PA 18709-1034
(570) 855-9459
Mailing address
816 NORTH ST, LUZERNE, PA 18709-1034
(570) 855-9459
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
SP016085
PA
363LG0600X
Gerontology Nurse Practitioner
SP016085
PA
363LP2300X
Primary Care Nurse Practitioner
Primary
SP016085
PA
Other
Enumeration date
05/09/2016
Last updated
05/09/2016
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