Fairfield Ave Family Practice
NPI #1114130929 in Johnstown, Pennsylvania
Provider Information
- NPI Number
- 1114130929
- Entity Type
- Organization
- Organization Name
- Fairfield Ave Family Practice
- Primary Specialty
- Family Medicine
- Enumeration Date
- May 8, 2007
- Last Updated
- Mar 3, 2016
Practice Location
- Address
- 226 FAIRFIELD AVE
- City
- Johnstown
- State
- Pennsylvania
- ZIP Code
- 15906-2310
- Phone
- (814) 535-6167
Authorized Official
- Name
- DR. CAROL ELIZABETH KOWTONIUK, D.O.
- Title
- VICE PRESIDENT
- Phone
- (814) 535-6167
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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