Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | OS018587 | PA |
Y | 207QS0010X | Family Doctor - Sports Medicine | OS018587 | PA |
NPI | 1164862801 |
---|---|
Provider Name | Bryan R Hess |
First Address | Hanover, PA 17331-1587 |
Second Address | Hanover, PA 17331-8350 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2013 |
Last Update Date | 25/01/2021 |