| NPI | 1972876472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT JOHN LAGERMAN Administrator 570-743-1703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2013-02-01 |