Organization
WYOMING VALLEY PET ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD J GRACE (DIRECTOR OF BILLING)
(610) 993-1640
Entity
Organization
Contact information
Practice address
190 WELLES ST, FORTY FORT, PA 18704-4968
(570) 331-7702
(570) 331-7704
Mailing address
43 LEOPARD RD, SUITE 200, PAOLI, PA 19301-1552
(610) 993-1640
(610) 993-1651
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
01/04/2006
Last updated
06/18/2008
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