Individual
JOLENE VERONICA RETALLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
350 N 11TH ST, SUNBURY, PA 17801-1611
(570) 286-3570
(570) 286-3322
Mailing address
409 SUSQUEHANNA ST, TREVORTON, PA 17881-1209
(570) 850-3936
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC008974
PA
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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