| NPI | 1154710192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA GONZALEZ Administrator 215-941-6289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT020411) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2015-01-14 |