| NPI | 1780752378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN ROACH CFO 814-234-6148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: PA 550301) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2021-10-04 |