| NPI | 1104058338 |
|---|---|
| Other Name | GAUDENZIA POTTSVILLE OUTPATIENT |
| Entity Type | Organization |
| Authorized Contact | MIKE WILLIAMS Sr. Contracting Manager 484-338-3731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: PA 547027) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2022-02-24 |