| NPI | 1114127065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH M. POOLE Owner/President 570-455-5893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: PA DC001991L PA) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2007-07-19 |