Individual
LAWRENCE FAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
618 CUMBERLAND ST, LEBANON, PA 17042-5232
(717) 274-2741
Mailing address
200 N 7TH ST, LEBANON, PA 17046-5040
(717) 272-5464
(717) 376-1712
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/22/2021
Last updated
09/22/2021
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