NPI | 1164621835 |
---|---|
Doing Business As | WATERFORD FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | GREGG A PEARSON Owner 609-561-5900 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NJ MB72474) |
Enumeration Date | 2007-07-13 |
Last Update Date | 2007-07-13 |