| NPI | 1124268198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL P. WALKER Owner 814-724-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: PA OEG000830) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: PA OEG000519) |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2009-10-28 |