Medical Group of Corry, Inc.

NPI #1639211204 in Corry, Pennsylvania

Provider Information

NPI Number
1639211204
Entity Type
Organization
Organization Name
Medical Group of Corry, Inc.
Subpart
Yes (part of a larger organization)
Parent Organization
MEDVANTX, INC.
Primary Specialty
Non-Pharmacy Dispensing Site
Enumeration Date
Feb 12, 2007
Last Updated
Oct 16, 2012

Practice Location

Address
315 YORK ST
City
Corry
ZIP Code
16407-1412
Phone
(814) 664-8686

Authorized Official

Name
KENNY HEINE
Title
DIRECTOR OF OPERATIONS
Phone
(858) 625-2990

Specialties & Taxonomy Codes

Specialty
Non-Pharmacy Dispensing Site

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