| NPI | 1992442255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID B KASPRZAK CEO 570-657-1634 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 335V00000X Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2022-05-18 |