| NPI | 1669423620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH HOLDREN CAO 570-271-5490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2008-06-27 |