| NPI | 1144487406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CICERON L OPIDA Owner 814-946-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: PA MD020883E) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2008-05-22 |