Individual
MARY V EAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 LINCOLN ST, RIDGWAY, PA 15853-1939
(814) 776-2145
Mailing address
110 LINCOLN ST, RIDGWAY, PA 15853-1939
(814) 776-2145
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PC004003
PA
Other
Enumeration date
11/21/2007
Last updated
11/21/2007
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