Individual
JOSEPH DZURISHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 MUNDY ST, WILKES BARRE, PA 18702-6830
(570) 826-3914
Mailing address
150 MUNDY ST, WILKES BARRE, PA 18702-6830
(570) 826-3914
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OC002648L
PA
Other
Enumeration date
05/18/2015
Last updated
05/18/2015
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