Individual
LYNN COLARUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
119 MOOSIC RD, OLD FORGE, PA 18518-2018
(570) 457-2240
Mailing address
119 MOOSIC RD, OLD FORGE, PA 18518-2018
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP000890L
PA
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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