Search › Pennsylvania › 390200000X
Austin Loop
NPI 1588416341 · on the registry since 2024
Practice
- Address
- 549 Fair St # Mc61-22
Bloomsburg, PA 17815 - Phone
- (570) 416-1925
- Clinicians at this address
- 11
Registry record
- Primary taxonomy
- 390200000X
390200000X
- Licence states on file
- NULL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-04-04
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Pennsylvania