| NPI | 1497021018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY M BOGER Credentialing COO Rdinator 717-270-7780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2016-10-05 |