| NPI | 1063466118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN ALLIE MORTAZAVI President 610-954-9040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: PA 2068) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2009-03-05 |