NPI | 1700212917 |
---|---|
Entity Type | Organization |
Authorized Contact | CINDY MULL Director 570-271-6144 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 363A00000X Physician Assistant |
363L00000X Nurse Practitioner | |
Enumeration Date | 2013-09-19 |
Last Update Date | 2019-02-28 |