Individual
CAROLYN FALLSTICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 E LANCASTER AVE, WYNNEWOOD, PA 19096-3450
(484) 476-2285
Mailing address
1735 MCNELIS DR, SOUTHAMPTON, PA 18966-4051
(717) 880-2972
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA053526
PA
Other
Enumeration date
09/04/2008
Last updated
09/22/2015
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