| NPI | 1154563237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH JAMES STRAIGHT Doctor 302-731-2888 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: DE C10008348) |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2009-04-03 |