| NPI | 1528616109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL Director 570-271-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 133N00000X Nutritionist |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2020-04-29 |