| NPI | 1669424537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH HOLDREN CAO 570-271-5490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease |
| 133N00000X Nutritionist | |
| 133V00000X Dietitian, Registered | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2008-06-27 |