| NPI | 1689885618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY MULL Director 570-271-6144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 136A00000X Dietetic Technician, Registered |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2019-02-28 |