| NPI | 1023067493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY MULL Director 570-271-6144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD417716) |
| Additional Taxonomies | 208000000X Pediatrics |
| 291U00000X Clinical Medical Laboratory | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2019-02-26 |