| NPI | 1033459094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJAA NEBBARI Tax Matters Member 570-780-4552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2013-02-27 |
| Last Update Date | 2015-02-11 |