| NPI | 1306809611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY T PETRICK Clinical Supervisor 570-455-7108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2010-07-27 |