| NPI | 1770285769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIANNE BALCHUNE Office Manager 570-800-5926 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2023-04-19 |