| NPI | 1841782869 |
|---|---|
| Doing Business As | MEADVILLE UROLOGY |
| Entity Type | Organization |
| Authorized Contact | CORY FRANK JACKSON Controller 814-333-5766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2018-08-08 |