| NPI | 1144402983 |
|---|---|
| Doing Business As | MEDI SCENE |
| Entity Type | Organization |
| Authorized Contact | EVERETT ROY FORMAN President 518-899-6657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2007-12-19 |