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Individual

TY MEDOVIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
460 WASHINGTON RD, SUITE 7, WASHINGTON, PA 15301-2765
(724) 225-3627
Mailing address
460 WASHINGTON RD, SUITE 7, WASHINGTON, PA 15301-2765

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA054473
PA

Other

Enumeration date
09/07/2010
Last updated
09/07/2010
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