| 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 |