| NPI | 1538691720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE WILLIAMS Credentialing Consultant 570-801-1847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0132X Clinic/Center Ophthalmologic Surgery |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2018-12-12 |