Individual
MS. AMY JO TOBAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
208 S ARCH ST, CONNELLSVILLE, PA 15425-3519
(724) 626-2630
Mailing address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007288440037
—
PA
05
—
328834A336347
—
PA
Enumeration date
11/28/2005
Last updated
04/15/2008
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