Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | OS017810 | PA |
N | 207Q00000X | Family Doctor | OT015777 | PA |
Y | 207QS0010X | Family Doctor - Sports Medicine | OS017810 | PA |
NPI | 1073923496 |
---|---|
Provider Name | Brandon Matthew Eck |
First Address | Lancaster, PA 17601-4132 |
Second Address | Lancaster, PA 17601-4132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2014 |
Last Update Date | 09/02/2021 |