Individual
MRS. LAURA SHALLENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
564 W BROAD ST, HAZLETON, PA 18201-6108
(570) 501-6400
(570) 453-2353
Mailing address
PO BOX 1830, ALLENTOWN, PA 18105-1830
(484) 862-3313
(484) 664-7659
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
TMA052595
PA
Other
Enumeration date
09/27/2011
Last updated
04/22/2020
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