| NPI | 1275935991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MYCKA President 610-469-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: PA DC006918R) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2014-09-24 |