| NPI | 1043405897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY MULL Director 570-271-6144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| 364S00000X Clinical Nurse Specialist | |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2019-02-26 |