Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | SC006547 | PA |
NPI | 1073928024 |
---|---|
Provider Name | Colleen Law |
First Address | Williamsport, PA 17701-1900 |
Second Address | Berwick, PA 18603-3024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2014 |
Last Update Date | 15/06/2021 |