Provider Information for 1881925485
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GEORGE P DYMIOTIS LPC
Sex: Male
NPI: 1881925485
Last Updated: 2020-12-22
Certification Date: 2020-12-22
Certification Date: 2020-12-22
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1881925485 | ||||||||||||
| Enumeration Date | 2010-01-21 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 647 PHILADELPHIA ST STE 402 INDIANA, PA 15701-3923 United States Phone: 765-404-6582 | Fax:814-690-2075 | ||||||||||||
| Primary Practice Address | 647 PHILADELPHIA ST STE 402 INDIANA, PA 15701-3923 United States Phone: 765-404-6582 | Fax:814-690-2075 | ||||||||||||
| Secondary Practice Address(es) | 670 N 36TH ST | ||||||||||||
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