| NPI | 1578871083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL Director 570-271-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2014-01-29 |