| NPI | 1649584459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER JOHN CARBO President 814-746-1447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: PA OS010329L) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2011-03-22 |