Organization
WILLIAMSPORT PHYSICAL MEDICINE, INC.
Active
Parent organization
WILLIAMSPORT PHYSICAL MEDICINE, INC.
Other names
Neuropathy Center of NEPA
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILLIAMSPORT PHYSICAL MEDICINE, INC.
Authorized official
FRANK J FORTE D.C. (PRESIDENT)
(570) 287-5560
Entity
Organization
Contact information
Practice address
1101 E 3RD ST, WILLIAMSPORT, PA 17701-5411
(570) 322-5500
(570) 322-8100
Mailing address
1101 E 3RD ST, WILLIAMSPORT, PA 17701-5411
(570) 322-5500
(570) 322-8100
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD433098
PA
332B00000X
Durable Medical Equipment & Medical Supplies
—
PA
363A00000X
Physician Assistant
MA052411
PA
363L00000X
Nurse Practitioner
RN523038L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2081099
BLUE CROSS BLUE SHIELD
PA
Enumeration date
12/08/2011
Last updated
02/19/2014
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