| NPI | 1558969741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY R NICCOLAI Executive Director 724-635-6801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2020-10-12 |