Organization
DOCTORS AND LAWYERS FOR A DRUG FREE YOUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS RADECKI M.D., J.D. (OWNER/MEDICAL DOCTOR)
(814) 226-4909
Entity
Organization
Contact information
Practice address
238 MAIN ST, CLARION, PA 16214-1043
(814) 226-4909
Mailing address
238 MAIN ST, CLARION, PA 16214-1043
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MD015591E
PA
2084P0802X
Addiction Psychiatry Physician
Primary
MD015591E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014336910002
—
PA
Enumeration date
12/28/2011
Last updated
12/28/2011
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