| NPI | 1114223393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL System Director 570-271-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2019-11-14 |