| NPI | 1700805850 |
|---|---|
| Other Name | SPS-WAGNER |
| Entity Type | Organization |
| Authorized Contact | CHARLES SANTANGELO Executive VP/CFO 570-321-3171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-08-22 |