| NPI | 1710142302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE M VARNEY Credentialing COO Rdinator 724-850-6933 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2020-05-07 |