NPI | 1265591481 |
---|---|
Doing Business As | PINE GROVE ADULT MEDICINE |
Entity Type | Organization |
Authorized Contact | AMY F WILKINSON Credentialing Coordinator 717-851-1405 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 363L00000X Nurse Practitioner |
Enumeration Date | 2006-12-06 |
Last Update Date | 2010-08-11 |