| NPI | 1699325688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE RISPO Practice Manager 570-202-6671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2019-09-13 |