| NPI | 1164507927 |
|---|---|
| Doing Business As | FAMILY PRACTICE OF RENOVO |
| Entity Type | Organization |
| Authorized Contact | FRANK L. CONLY President 570-923-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2008-07-01 |