Individual
LOAYMA LUZ TUSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5220 WINDING WAY, HARRISBURG, PA 17109-6343
(717) 743-9247
Mailing address
5220 WINDING WAY, HARRISBURG, PA 17109-6343
(717) 743-9247
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
29665908
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
88-1122234
IRS
—
Enumeration date
07/13/2022
Last updated
07/13/2022
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