| NPI | 1063621233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN E GREULICK Owner 570-675-7955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD024845E) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: PA 022874) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |