| NPI | 1477502847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH HOLDREN CAO 570-271-5490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| 207T00000X Neurological Surgery | |
| 204F00000X Transplant Surgery | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2008-06-27 |