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 |