| NPI | 1407253859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE TEYGART Manager 814-528-1695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS014970) |
| 207QA0505X Family Medicine, Adult Medicine | |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2020-09-24 |