| NPI | 1487912804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN J MARIEN Owner 570-714-2720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: PA MD073237L) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2022-07-21 |