| NPI | 1730532359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BOUDREAU Owner/Doctor 717-805-8264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care (Licence: VA 0101258315) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-10-13 |