Organization
SOUTH SIDE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN SKILES (BILLING)
(570) 507-9517
Entity
Organization
Contact information
Practice address
1831 PITTSTON AVE, SCRANTON, PA 18505-1651
(570) 507-9517
Mailing address
1831 PITTSTON AVE, SCRANTON, PA 18505-1651
(570) 507-9517
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
207Q00000X
PA
Other
Enumeration date
04/25/2016
Last updated
04/25/2016
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