Organization
LYCOMING PHYSICAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ALLEN HAMPTON D.C. (CEO)
(570) 916-4897
Entity
Organization
Contact information
Practice address
1111 E 3RD ST, WILLIAMSPORT, PA 17701-5411
(570) 916-4897
(570) 322-8100
Mailing address
1111 E 3RD ST, WILLIAMSPORT, PA 17701-5411
(570) 916-4897
(570) 322-8100
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC004453L
PA
207R00000X
Internal Medicine Physician
MD045007L
PA
332B00000X
Durable Medical Equipment & Medical Supplies
MD070043L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC004453L
LICENSE
PA
Enumeration date
01/29/2014
Last updated
06/12/2015
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