| NPI | 1265867113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL System Director Enrollments 570-271-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2020-03-31 |