| NPI | 1295761666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH D MCKIBBIN Shareholder 814-946-5469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: PA MD439868) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2016-06-16 |