| NPI | 1437007515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE DANIELLE POESNECKER Owner 570-417-5308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2026-03-17 |
| Last Update Date | 2026-04-02 |