| NPI | 1306034236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL JANE WALLACE Office Manager 570-341-5544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC0004338-L) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2007-10-04 |