| NPI | 1578575007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN S. FRAZIER Billing Supervisor 717-838-6462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD016889E) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2020-08-22 |