| NPI | 1790128254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL System Director Enrollment 570-271-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1100X Technician/Technologist, Ophthalmic |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2025-08-07 |