| NPI | 1255362778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY MULL Director 570-271-6144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2019-08-19 |