Organization
NULTON DIAGNOSTIC AND TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY NULTON (OWNER)
(814) 262-0025
Entity
Organization
Contact information
Practice address
220 COLLEGE PARK PLAZA, JOHNSTOWN, PA 15904
(814) 266-0025
(814) 266-8745
Mailing address
220 COLLEGE PARK PLAZA, JOHNSTOWN, PA 15904
(814) 266-0025
(814) 266-8745
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
313430
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007324900004
—
PA
Enumeration date
04/13/2007
Last updated
08/22/2020
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