| NPI | 1518345602 |
|---|---|
| Doing Business As | LYCOMING PHYSICAL MEDICINE WILLIAMSPORT DME |
| Entity Type | Organization |
| Authorized Contact | MARK ALLEN HAMPTON CEO 570-326-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: PA MD045007L) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-05-12 |