Organization
ELK REGIONAL PROFESSIONAL GROUP, INC.
Active
Other names
ERPG Platt Family Practice Lab - Johnsonburg
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RITA V OLSZEWSKI (ADMINISTRATOR)
(814) 788-8580
Entity
Organization
Contact information
Practice address
111 COBB ST, JOHNSONBURG, PA 15845-1209
(814) 965-2857
(814) 965-2523
Mailing address
763 JOHNSONBURG RD, SAINT MARYS, PA 15857-3417
(814) 965-2857
(814) 965-2523
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
029511
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018592850042
—
PA
Enumeration date
05/10/2007
Last updated
08/22/2020
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