| NPI | 1013624097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL ANTHONY SHROM Chief Executive Officer 215-896-0422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2022-12-01 |