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Organization
MEDICAL PROFESIONAL SERVICE, PC
Active
Organization
MEDICAL PROFESIONAL SERVICE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP JAMES MERTZ PHD (DIRECTOR OF CLINICAL SERVICES)
(570) 288-4205
Entity
Organization
Contact information
Practice address
675 WYOMING AVE, KINGSTON, PA 18704-3831
(570) 288-4205
Mailing address
675 WYOMING AVE, KINGSTON, PA 18704-3831
(570) 288-4205
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
02/01/2007
Last updated
10/22/2010
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