| NPI | 1497628192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERICK NOWACKI CEO 814-688-7793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2025-09-29 |
| Last Update Date | 2025-09-29 |