| NPI | 1801177431 |
|---|---|
| Doing Business As | SOUTH RIDGE FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JASON N. ROEBACK President 814-877-4242 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2011-09-09 |