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Individual

GINA LAVERNE CHARLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
565 E CHOCOLATE AVE, HERSHEY, PA 17033
(717) 533-4935
Mailing address
565 E CHOCOLATE AVE, HERSHEY, PA 17033-1325
(717) 533-4935

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS017893
PA
207Q00000X
Family Medicine Physician
OT015547
PA

Other

Enumeration date
10/15/2013
Last updated
01/31/2019
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