| NPI | 1154325686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMENIC C IZZO Medical Director 610-736-0144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: PA 15291501) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2009-11-20 |