| NPI | 1124374400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM O'BRIEN Member 215-378-0351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: PA OS008318L) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2013-01-16 |