# MEDICAL PROFESIONAL SERVICE, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821136227
- **Authorized official:** DR. PHILIP JAMES MERTZ PHD (DIRECTOR OF CLINICAL SERVICES)
- **Authorized official phone:** (570) 288-4205

## Contact information

- **Practice address:** 675 WYOMING AVE, KINGSTON, PA 18704-3831
- **Practice address phone:** (570) 288-4205
- **Mailing address:** 675 WYOMING AVE, KINGSTON, PA 18704-3831
- **Mailing address phone:** (570) 288-4205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/01/2007
- **Last updated:** 10/22/2010