| NPI | 1659680924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA NEWELL Office Manager 570-420-9777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: PA MD029804L) |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2010-10-04 |