Ideal Pediatric and Adolescent Care
NPI #1154879096 in Lewisburg, Pennsylvania
Provider Information
- NPI Number
- 1154879096
- Entity Type
- Organization
- Organization Name
- Ideal Pediatric and Adolescent Care
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Sep 21, 2016
- Last Updated
- Sep 21, 2016
Practice Location
- Address
- 121 JPM RD
- City
- Lewisburg
- State
- Pennsylvania
- ZIP Code
- 17837-9313
- Phone
- (570) 551-0300
Authorized Official
- Name
- DR. MARY BETH ANN O'HARA, D.O.
- Title
- PRESIDENT
- Phone
- (570) 551-0300
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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