| NPI | 1104952829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL System Director Enrollment 570-271-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207ZP0101X Pathology, Anatomic Pathology | |
| 208000000X Pediatrics | |
| 291U00000X Clinical Medical Laboratory | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2023-01-23 |