| NPI | 1639747462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL Director 570-271-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2021-10-08 |