Individual
KYLE MATTHEW MUMMEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
19 BANKS AVE, SUGARLOAF, PA 18249-3700
(570) 788-5104
Mailing address
PO BOX 197, SHEPPTON, PA 18248-0197
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA052827
PA
363AM0700X
Medical Physician Assistant
MA052827
PA
Other
Enumeration date
02/16/2007
Last updated
04/07/2022
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