| NPI | 1376979534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL System Director Enrollments 570-271-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2020-04-09 |