Individual
DEBORAH WASNOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1424 LEWIS LAKE RD, UNION DALE, PA 18470-4541
(570) 960-2571
Mailing address
1424 LEWIS LAKE RD, PO BOX 71, UNION DALE, PA 18470-4541
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN252562L
PA
Other
Enumeration date
09/09/2013
Last updated
09/09/2013
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