| NPI | 1285981407 |
|---|---|
| Doing Business As | STATE STREET PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | DENNIS M STYN President 814-868-2504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2012-12-18 |