| NPI | 1063693828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD JOSEPH GREEN Doctor 814-535-5841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA md029508e) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: PA md029508e) |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2007-11-21 |