| Keystone Functional Medicine, Pc | |
|
1689 Crown Ave Ste 5 Lancaster PA 17601 | |
| (717) 273-3741 | |
| (717) 585-6794 |
| Full Name | Keystone Functional Medicine, Pc |
|---|---|
| Speciality | General Practice |
| Location | 1689 Crown Ave Ste 5, Lancaster, Pennsylvania |
| Authorized Official Name and Position | Adam Sechrist (MANAGER) |
| Authorized Official Contact | 7175158116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keystone Functional Medicine, Pc 1689 Crown Ave Ste 5 Lancaster PA 17601-6314 Ph: (717) 273-3741 | Keystone Functional Medicine, Pc 1689 Crown Ave Ste 5 Lancaster PA 17601 Ph: (717) 273-3741 |
| NPI Number | 1962911750 |
|---|---|
| Provider Enumeration Date | 09/25/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 8527310952 |
|---|---|
| Medicare Enrollment ID | O20181011002007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962911750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Mary E Regan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134447998 PECOS PAC ID: 9739219197 Enrollment ID: I20100610000816 |
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