Private Practice
NPI #1093122954 in Fredericktown, Pennsylvania
Provider Information
- NPI Number
- 1093122954
- Entity Type
- Organization
- Organization Name
- Private Practice
- Primary Specialty
- In Home Supportive Care
- Enumeration Date
- Jul 11, 2014
- Last Updated
- Jul 11, 2014
Practice Location
- Address
- 202 FISHPOT RD
- City
- Fredericktown
- State
- Pennsylvania
- ZIP Code
- 15333-2203
- Phone
- (724) 322-7745
Authorized Official
- Name
- KELLY MCCONNELL
- Title
- RN
- Phone
- (724) 322-7745
Specialties & Taxonomy Codes
| Specialty |
|---|
| In Home Supportive Care |
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