| NPI | 1295725711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTI POTTER Administrator 302-644-6992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: DE FSSC-012) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2008-06-06 |