| NPI | 1053306555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA DREVENIK Director Practice Operations 570-283-0205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2020-08-22 |