Individual
REBECCA JEIRLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
980 E WATER ST, LOCK HAVEN, PA 17745-1514
(570) 748-3928
(570) 748-3610
Mailing address
980 E WATER ST, LOCK HAVEN, PA 17745-1514
(570) 748-3928
(570) 748-3610
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022784270001
—
PA
Enumeration date
01/21/2016
Last updated
01/21/2016
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