Individual
KATELYN S PONSOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5535 PEACH ST FL 1, ERIE, PA 16509-2603
(814) 868-3488
(814) 868-3499
Mailing address
1 LECOM PL, ERIE, PA 16505-2571
(814) 868-2529
(814) 868-2522
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
MA059802
PA
363AM0700X
Medical Physician Assistant
Primary
OA007090
PA
Other
Enumeration date
07/19/2018
Last updated
11/26/2024
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