Organization · NPI-2

Susquehanna Physician Services

Physical Medicine & Rehabilitation · Williamsport, PA

NPI number1629006606
StatusActive
Last updated in NPPESOct 20, 2015

Details

NPI
1629006606
Entity type
Organization (NPI-2)
Legal business name
Susquehanna Physician Services
Organization subpart
No
Enumeration date
Jun 29, 2006
Last updated
Oct 20, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208100000X Physical Medicine & Rehabilitation––Yes
2084N0400X Psychiatry & Neurology, Neurology––
363A00000X Physician Assistant––

Other names

  • Susquehanna Health Medical Group (Doing Business As)

Practice location

700 High Street
Williamsport, PA 17701-3198

Phone 570-321-2619 · Fax 570-321-2670

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900

Authorized official

Melissa Davis
Vp/Coo
5703207696

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