| NPI | 1407382633 |
|---|---|
| Doing Business As | WELLSPAN FAMILY MEDICINE - 207 W FULTON ST |
| Entity Type | Organization |
| Authorized Contact | CHRISTINA MOON Credentialing Supervisor 717-851-1405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2017-05-09 |
| Last Update Date | 2017-05-09 |