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
—
—
Other
Enumeration date
02/01/2007
Last updated
10/22/2010
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