Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MZG002778 | PA |
NPI | 1487922142 |
---|---|
Provider Name | Mr. Frank James Dotts JR. |
First Address | Clearfield, PA 16830-2547 |
Second Address | Clearfield, PA 16830-2547 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2011 |
Last Update Date | 09/12/2011 |