| NPI | 1144413097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WEDELL Owner 215-784-9711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: PA DSO25939L) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2007-08-23 |