Organization
SHELLBY CUSTER LSW, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLBY CUSTER LSW (DIRECTOR)
(814) 242-1125
Entity
Organization
Contact information
Practice address
1360 EISENHOWER BLVD, STE 402, JOHNSTOWN, PA 15904-3338
(814) 242-1125
Mailing address
1360 EISENHOWER BLVD, STE 402, JOHNSTOWN, PA 15904-3338
(814) 242-1125
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SW125419
PA
Other
Enumeration date
04/12/2012
Last updated
04/12/2012
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