| NPI | 1528519949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIANN HALL Manager 570-357-9864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD058608L) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 053927) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD20481) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME123941) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 202292) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 26357) | |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-10-20 |