| NPI | 1588399745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MICHAEL BUCY Senior Reimbursement Manager 717-383-0392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 163WI0500X Registered Nurse Infusion Therapy |
| 208VP0000X Pain Medicine Pain Medicine | |
| 261QI0500X Clinic/Center Infusion Therapy | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-07-21 |
| Last Update Date | 2025-05-09 |