Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD468802 | PA |
NPI | 1003278201 |
---|---|
Provider Name | Georgia Perry |
First Address | Lancaster, PA 17601-4207 |
Second Address | Lancaster, PA 17601-4207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2016 |
Last Update Date | 16/09/2019 |