Individual
ERIC BLAZE DEGELOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 231-8772
Mailing address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 231-8772
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SPO27130
PA
Other
Enumeration date
02/16/2023
Last updated
10/17/2023
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