| NPI | 1912295692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI L DATRES Chairman 570-916-5554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC010094) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC010095) |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2011-07-15 |