| NPI | 1467166488 |
|---|---|
| Former Legal Business Name | NONE |
| Entity Type | Organization |
| Authorized Contact | TITUS LEITORO Partner 717-869-6710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| 2083A0300X Preventive Medicine, Addiction Medicine | |
| Enumeration Date | 2023-01-13 |
| Last Update Date | 2023-01-13 |