Individual
GINGER OUTLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
345 WEST ALY, LEHIGHTON, PA 18235-1410
(610) 377-7861
Mailing address
345 WEST ALY, LEHIGHTON, PA 18235-1410
(610) 377-7861
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN284224
PA
Other
Enumeration date
09/17/2010
Last updated
09/17/2010
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