| NPI | 1912290537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM RANDOLPH BLODGETT President 570-275-0901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: PA OEG001014) |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2011-05-19 |