| NPI | 1225447592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA KAY JOHNSON CFO 215-644-8745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2024-03-19 |