Organization
LYCOMING PHYSICAL MEDICINE
Active
Other names
Lycoming Physical Medicine Kingston DME
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ALLEN HAMPTON D.C. (CEO)
(570) 326-0400
Entity
Organization
Contact information
Practice address
250 PIERCE ST, SUITE 103, KINGSTON, PA 18704-5149
(570) 916-4897
Mailing address
1111 E 3RD ST, WILLIAMSPORT, PA 17701-5411
(570) 326-0400
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
MD045007L
PA
Other
Enumeration date
05/11/2015
Last updated
05/12/2015
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