Graduated: 1985
NPI: 1457453326
Practice Locations (4)
111 S FRONT ST
HARRISBURG, PA 171012010
409 S 2ND ST
HARRISBURG, PA 171041612
PO BOX, SUITE 16
State College, PA 168040016
PO BOX, SUITE 16
STATE COLLEGE, PA 168040016
Source: CMS National Downloadable File, September 2026.