| NPI | 1033256763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANITA HENSON Administrative Assistant 717-230-3906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2017-08-30 |