Organization
WYOMING VALLEY PAIN CLINIC & REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMMANUEL E. JACOB M.D. (DIRECTOR)
(570) 822-9514
Entity
Organization
Contact information
Practice address
39 S RIVER ST, PLAINS, PA 18705-1233
(570) 822-9514
(570) 823-8039
Mailing address
39 S RIVER ST, PLAINS, PA 18705-1233
(570) 822-9514
(570) 823-8039
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD026644E
PA
Other
Enumeration date
04/02/2007
Last updated
08/22/2020
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