| NPI | 1154409472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOT ROBERT MCKENNA Owner/President 570-340-6920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: PA MD054788-L) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2011-01-20 |