| NPI | 1790796100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VAL MIGNOGNA Practice Manager 814-941-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: PA 010099A) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2012-10-26 |