Intermountain Medical Group, INC
NPI #1932271624 in Kingston, Pennsylvania
Provider Information
- NPI Number
- 1932271624
- Entity Type
- Organization
- Organization Name
- Intermountain Medical Group, INC
- Primary Specialty
- Clinical Medical Laboratory
- Enumeration Date
- Nov 15, 2006
- Last Updated
- Jul 13, 2011
Practice Location
- Address
- 610 WYOMING AVE
- City
- Kingston
- State
- Pennsylvania
- ZIP Code
- 18704-3702
- Phone
- (570) 288-5441
Authorized Official
- Name
- DR. ROBERT CZWALINA, D.O.
- Title
- LABORATORY DIRECTOR
- Phone
- (570) 288-5441
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinical Medical Laboratory |
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