| NPI | 1245632231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL Director Credentialing & Enrollment 570-271-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Additional Taxonomies | 213E00000X Podiatrist |
| 213ER0200X Podiatrist, Radiology | |
| 163WW0000X Registered Nurse, Wound Care | |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: PA 071801) | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 211D00000X Assistant, Podiatric | |
| 213ES0000X Podiatrist, Sports Medicine | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 213ES0131X Podiatrist, Foot Surgery | |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2020-09-08 |