| NPI | 1255729695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A BOTTGER Doctor 610-355-1929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: PA MD045572-E) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2015-01-08 |