Individual
JESSICA EICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
175 S WILKES BARRE BLVD, WILKES BARRE, PA 18702-5040
(570) 829-2621
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0922330
PA
363A00000X
Physician Assistant
Primary
MA051241
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0922330
—
PA
Enumeration date
11/13/2007
Last updated
03/19/2020
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