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Organization
MAXIS MEDICAL SERVICES
Active
Organization
MAXIS MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY THERESA VAUTRINOT (CHIEF EXECUTIVE OFFICER)
(570) 281-1315
Entity
Organization
Contact information
Practice address
100 LINCOLN AVE, CARBONDALE, PA 18407-2116
(570) 281-1315
(570) 281-1256
Mailing address
100 LINCOLN AVE, CARBONDALE, PA 18407-2116
(570) 281-1315
(570) 281-1256
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/02/2006
Last updated
08/22/2020
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