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 |