| NPI | 1275649824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID EVANS WILDMAN Physician/Owner 610-407-9490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS010018L) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2020-08-22 |