| NPI | 1760582225 |
|---|---|
| Doing Business As | MT VERNON MEDICAL, INC |
| Entity Type | Organization |
| Authorized Contact | JANICE GRACIA ALLEN Owner 724-437-9858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: PA md019358e) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2022-07-21 |