| NPI | 1841588571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN SCOTT MILES Regional Director 570-348-7489 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: PA MD434966) |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2011-07-15 |