Ideal Pediatric And Adolescent Care
Clinic/Center in Lewisburg, PA(View on Map)
Legal Business Name
Ideal Pediatric And Adolescent Care
NPI Number
1154879096
NPI Type
Organization
Enumeration Date
09/21/2016
Specialties
(Taxonomies)Licenses
State
Pennsylvania
License Number
OS008495L
Contact
Information
Purpose
Mailing
Location
Address
121 JPM RD
121 JPM RD
City
Lewisburg
Lewisburg
State
PA
PA
Postal Code
17837-9313
17837-9313
Country
US
US
Telephone Number
(570) 551-0300
(570) 551-0300
Authorized Official
Name
Dr. Mary Beth O'Hara
Title or Position
PRESIDENT
Telephone Number
(570) 551-0300
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 09/21/2016
Provider Address
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