Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2012-11-12
- Last updated
- 2020-01-23
Licenses
The registry row did not include a license.
Location
- Practice location
- 26 STATION CIR
- City
- HAZLETON PA
- Postal code
- 182029726
- Phone
- 610-861-8080
Organization contact
- Name
- AMY NYBERG
- Title
- President & COO
- Phone
- 6108618080
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.