| NPI | 1962975615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN M WONG Owner 724-527-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| Enumeration Date | 2019-01-05 |
| Last Update Date | 2023-02-09 |