Organization
BLAIR NEUROLOGIC ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURENCE ALAN PRIMACK MD (PRESIDENT)
(814) 201-2309
Entity
Organization
Contact information
Practice address
914 S 12TH ST, ALTOONA, PA 16602-6247
(814) 201-2309
(814) 301-2389
Mailing address
914 S 12TH ST, ALTOONA, PA 16602-6247
(814) 201-2309
(814) 301-2389
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD038175E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019607820001
—
PA
Enumeration date
08/04/2006
Last updated
09/26/2019
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