| NPI | 1629609490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMMON LARSEN Owner 717-480-2132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 207ND0900X Dermatology, Dermatopathology | |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2022-11-11 |