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Individual

COLLEEN MARGARET LIZEWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
40 W FRACK ST, FRACKVILLE, PA 17931-1719
(570) 794-6123
(570) 794-6124
Mailing address
40 W FRACK ST, FRACKVILLE, PA 17931-1719
(570) 794-6123
(570) 794-6124

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
OA004346
PA
363AM0700X
Medical Physician Assistant
0010-14034
NC
363AM0700X
Medical Physician Assistant
Primary
MA055811
PA

Other

Enumeration date
01/14/2014
Last updated
10/14/2024
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